License Verification

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LEONARD WILLIAM SIMMONS

License Number: PA9103209

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9103209
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/19/2005
Address of Record
Heritage Square One
4835 LBJ Freeway Suite 900
DALLAS, TX 75244
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1613 N McKensie St. South Baldwin Regional Medical Center
FOLEY, AL 36535
Address
151 EAST REDSTONE AVENUE NORTH OKALOOSA MEDICAL CENTER
CRESTVIEW, FL 32539
Address
6002 Berryhill Rd
MILTON, FL 32570
Name Relationship Profession License Effective Date
ALLMAN, JEFFREY WILLIAM Supervising Prescribing Practitioner Osteopathic Physician 9007 07/19/2023
ARBUCKLE, SEAN SR Supervising Prescribing Practitioner Osteopathic Physician 11132 07/17/2019
BARDINELLI, JOSEPH DO Supervising Prescribing Practitioner Osteopathic Physician 15844 04/18/2019
BERRY, SHANNON GAYLE Supervising Prescribing Practitioner Medical Doctor 152055 06/17/2021
BORUP, MIKEL ELIAS Supervising Prescribing Practitioner Osteopathic Physician 16398 03/11/2020
BRADLEY, REBECCA Supervising Prescribing Practitioner Medical Doctor 147611 01/10/2024
BULLMAN, JONATHAN FAIN Supervising Prescribing Practitioner Physician Assistant 9107709 07/29/2021
COOK, DARREN LEE Supervising Prescribing Practitioner Osteopathic Physician 5856 09/15/2017
CRINER, ROGER D JR Supervising Prescribing Practitioner Medical Doctor 114331 06/21/2021
CUPO, WILLIAM WALTER MD Supervising Prescribing Practitioner Medical Doctor 86389 09/14/2022
DUERR, KARL MICHAEL Supervising Prescribing Practitioner Medical Doctor 151983 07/29/2021
EDLER, RAYME MICHELLE Supervising Prescribing Practitioner Medical Doctor 109913 04/18/2019
EVERETT, WARREN UMANDAP Supervising Prescribing Practitioner Physician Assistant 9105831 07/29/2021
GAILMARD, WILLIAM ROBERT Supervising Prescribing Practitioner Medical Doctor 138184 07/17/2019
GEORGE, MATTHEW Supervising Prescribing Practitioner Medical Doctor 164808 10/12/2023
HAMPTON, ZACHARY EDWARD Supervising Prescribing Practitioner Osteopathic Physician 18067 07/13/2023
HARVEY, KYLE Supervising Prescribing Practitioner Medical Doctor 158195 07/25/2023
HINSHELWOOD, HEATHER LYN Supervising Prescribing Practitioner Medical Doctor 102798 01/11/2021
HWANG, CHARLES WILLIAM JR Supervising Prescribing Practitioner Medical Doctor 126436 07/13/2023
KOERTNER, ADAM Supervising Prescribing Practitioner Medical Doctor 157233 08/16/2023
LANG, JUERGEN Supervising Prescribing Practitioner Medical Doctor 164763 10/14/2024
LATHAM, JOSHUA LUKE DO Supervising Prescribing Practitioner Osteopathic Physician 10027 03/08/2018
LITTMAN, NICHOLAS Supervising Prescribing Practitioner Medical Doctor 151791 10/11/2022
MATTEUZZI, KATIE LOU Supervising Prescribing Practitioner Osteopathic Physician 19359 02/13/2024
MCNEIL, MEGAN IONE Supervising Prescribing Practitioner Medical Doctor 129689 05/20/2020
MEIS, DANIEL ROBERT Supervising Prescribing Practitioner Osteopathic Physician 19686 07/13/2023
MELANCON, ERIC EUGENE Supervising Prescribing Practitioner Medical Doctor 150172 07/29/2021
MULLIS, BARON THAXTON Supervising Prescribing Practitioner Medical Doctor 113789 06/09/2021
NODINE, STEVEN LEE Supervising Prescribing Practitioner Osteopathic Physician 11996 11/28/2016
NOGGLE, TOMMY STEVEN MD Supervising Prescribing Practitioner Medical Doctor 93880 07/29/2021
NUCHERENO, ANTHONY RICHARD Supervising Prescribing Practitioner Osteopathic Physician 17869 06/26/2023
OWEN, STEPHANIE LEANN Supervising Prescribing Practitioner Medical Doctor 127333 04/30/2020
PATEL, JAIMIN BALWANT M D Supervising Prescribing Practitioner Medical Doctor 104797 11/28/2016
PORTER, JAYCE Supervising Prescribing Practitioner Osteopathic Physician 16341 01/08/2020
RAK, TIMOTHY AARON Supervising Prescribing Practitioner Medical Doctor 83486 03/11/2020
RASIWALA, AZIMA Supervising Prescribing Practitioner Osteopathic Physician 18254 01/03/2022
REVILLA, RICARDO ARSENIO Supervising Prescribing Practitioner Medical Doctor 106166 03/11/2020
RIZZUTO, WILLIAM THOMAS Supervising Prescribing Practitioner Medical Doctor 161389 07/13/2023
RUTH, ROBERT ALLAN Supervising Prescribing Practitioner Medical Doctor 74008 07/25/2023
SCHANDER, ARTUR Supervising Prescribing Practitioner Osteopathic Physician 15691 03/11/2020
SHEA, JILL MARIE Supervising Prescribing Practitioner Medical Doctor 136840 07/21/2023
THOMPSON, TOMMY GLEN II Supervising Prescribing Practitioner Medical Doctor 128635 07/25/2017
WALKER, ROBERT KENNETH Supervising Prescribing Practitioner Medical Doctor 163903 07/26/2023
WEST, KERRI ELESE Supervising Prescribing Practitioner Osteopathic Physician 18404 10/20/2021
WESTBROOK, JAMES WESLEY Supervising Prescribing Practitioner Medical Doctor 146630 07/30/2020
ZAHERI, KAMRAN Supervising Prescribing Practitioner Medical Doctor 136667 10/01/2018

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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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