License Verification

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MARC DALE DAVIS

License Number: PA9102789

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9102789
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
05/07/2004
Address of Record
500 Winderley Pl
Suite 115
MAITLAND, FL 32751
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
200 N. LAKEMONT AVE WINTER PARK MEMORIAL HOSPITAL
WINTER PARK, FL 32792
Address
601 E. ALTAMONTE DRIVE FLORIDA HOSPITAL ALTAMONTE
ALTAMONTE SPRINGS, FL 32701
Address
7727 LAKE UNDERHILL ROAD FLORIDA HOSPITAL EAST
ORLANDO, FL 32822
Name Relationship Profession License Effective Date
OLIVEIRA, EDUARDO C CAMACHO MD Supervising Prescribing Practitioner Medical Doctor 81926 12/13/2021
PAGE, ERNEST II Supervising Prescribing Practitioner Medical Doctor 78546 09/08/2023

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



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** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


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