License Verification
JERRY LEE STORK JR
License Number: PA9103513
Data As Of 12/2/2024
- Address
- 168 Broken Arrow Trail
- PETAL, MS 39465
- Address
- 15200 Community Rd
- PETAL, MS 39465
Name | Relationship | Profession | License | Effective Date |
---|---|---|---|---|
ALONSO, LEONARDO LAZARO | Supervising Prescribing Practitioner | Osteopathic Physician | 6584 | 12/19/2018 |
ATTLESEY, MARK GRAHAM | Supervising Prescribing Practitioner | Medical Doctor | 71653 | 12/20/2018 |
AYCOCK, RYAN DON | Supervising Prescribing Practitioner | Medical Doctor | 118284 | 09/26/2018 |
BAKOR, NADIA | Supervising Prescribing Practitioner | Medical Doctor | 131303 | 12/20/2018 |
BARKHUIZEN, CHRISTY H DO | Supervising Prescribing Practitioner | Osteopathic Physician | 9479 | 09/26/2018 |
BEAZLEY, WILLIAM WALTON DO | Supervising Prescribing Practitioner | Osteopathic Physician | 9930 | 09/26/2018 |
BESSER, KATHLEEN CORINNE DO | Supervising Prescribing Practitioner | Osteopathic Physician | 11756 | 09/26/2018 |
BLAKE, STEVEN MITCHELL M D | Supervising Prescribing Practitioner | Medical Doctor | 58519 | 12/20/2018 |
BRUNIOUS, BURNELL PAUL | Supervising Prescribing Practitioner | Medical Doctor | 104848 | 09/26/2018 |
CASTELLON-VOGEL, CARLOS H MD | Supervising Prescribing Practitioner | Medical Doctor | 46096 | 09/26/2018 |
CHAPMAN, JENNIFER COLES | Supervising Prescribing Practitioner | Medical Doctor | 125751 | 12/20/2018 |
CLONTZ, ROBERT MICHAEL II | Supervising Prescribing Practitioner | Medical Doctor | 129523 | 09/26/2018 |
DAVIS, DAVID RICHARD | Supervising Prescribing Practitioner | Medical Doctor | 96442 | 12/20/2018 |
DESCALLAR, EDWARD ALLEN | Supervising Prescribing Practitioner | Medical Doctor | 135003 | 12/20/2018 |
DEUTSCH, LEISA MARIE ROSSELLO | Supervising Prescribing Practitioner | Medical Doctor | 134059 | 09/26/2018 |
DURANT, CHRISTOPHER | Supervising Prescribing Practitioner | Osteopathic Physician | 12105 | 09/26/2018 |
EUWEMA, MICHAEL SCOTT | Supervising Prescribing Practitioner | Medical Doctor | 91648 | 12/20/2018 |
FARR, JORDAN TAYLOR | Supervising Prescribing Practitioner | Osteopathic Physician | 15015 | 12/20/2018 |
GONZALES, LEO T | Supervising Prescribing Practitioner | Medical Doctor | 74826 | 09/26/2018 |
GOODFRIEND, STEVEN DAVID | Supervising Prescribing Practitioner | Medical Doctor | 84608 | 12/19/2018 |
GROVES, KEVIN DALE | Supervising Prescribing Practitioner | Medical Doctor | 105815 | 09/26/2018 |
HAYNES, DAVID W | Supervising Prescribing Practitioner | Osteopathic Physician | 11905 | 09/26/2018 |
HYBART, JOHN L MD | Supervising Prescribing Practitioner | Medical Doctor | 22382 | 09/26/2018 |
JENKINS, FREDERICK LUCAS | Supervising Prescribing Practitioner | Medical Doctor | 83245 | 12/20/2018 |
KAUFMAN, NESREEN HANNA | Supervising Prescribing Practitioner | Medical Doctor | 121116 | 09/26/2018 |
KEENER, JANEL LAURA | Supervising Prescribing Practitioner | Medical Doctor | 115434 | 12/20/2018 |
KING, FORREST JOSEPH | Supervising Prescribing Practitioner | Medical Doctor | 124146 | 12/20/2018 |
KING, KENNETH | Supervising Prescribing Practitioner | Osteopathic Physician | 8648 | 12/20/2018 |
KOURY, RONALD FORREST D O | Supervising Prescribing Practitioner | Osteopathic Physician | 8090 | 12/20/2018 |
LAMOND, RYAN DANIEL | Supervising Prescribing Practitioner | Medical Doctor | 106090 | 12/19/2018 |
LISS, BENJAMIN EDWARD | Supervising Prescribing Practitioner | Medical Doctor | 127752 | 09/26/2018 |
MATHAI, ALEX | Supervising Prescribing Practitioner | Medical Doctor | 122229 | 12/20/2018 |
MENZE, ROGER MICHEEL | Supervising Prescribing Practitioner | Medical Doctor | 68199 | 12/20/2018 |
MORRISON, EDWARD SCOTT | Supervising Prescribing Practitioner | Osteopathic Physician | 8010 | 09/26/2018 |
NAVARRO, GUILLERMO ALBERTO | Supervising Prescribing Practitioner | Medical Doctor | 135153 | 09/26/2018 |
NAVO, DAVID JOEL JR | Supervising Prescribing Practitioner | Medical Doctor | 135494 | 09/26/2018 |
OLIVER, RADAMES ALBERTO | Supervising Prescribing Practitioner | Medical Doctor | 67906 | 12/19/2018 |
PAPAVASILIOU, JOHN JOSEPH | Supervising Prescribing Practitioner | Medical Doctor | 66371 | 12/19/2018 |
PERRY, DEBRA L | Supervising Prescribing Practitioner | Medical Doctor | 119490 | 09/26/2018 |
QUADER, MOHAMMED AZIZUL | Supervising Prescribing Practitioner | Medical Doctor | 91402 | 12/19/2018 |
REESE, JOHN LANCE | Supervising Prescribing Practitioner | Medical Doctor | 63197 | 09/26/2018 |
ROSEL, GEORGANNA MICHELLE | Supervising Prescribing Practitioner | Medical Doctor | 134082 | 12/20/2018 |
SCHRANDT, ERIC | Supervising Prescribing Practitioner | Medical Doctor | 136791 | 09/26/2018 |
SEAMAN, RYAN J | Supervising Prescribing Practitioner | Osteopathic Physician | 12746 | 09/26/2018 |
SLOTT, EDWIN FREDERICK | Supervising Prescribing Practitioner | Medical Doctor | 120515 | 12/19/2018 |
STAVROS, MARK GEORGE | Supervising Prescribing Practitioner | Medical Doctor | 71124 | 09/26/2018 |
SUMRALL, ARTHUR TIMOTHY II | Supervising Prescribing Practitioner | Medical Doctor | 94665 | 09/26/2018 |
SWANSON, TERRELL E JOHN | Supervising Prescribing Practitioner | Medical Doctor | 111251 | 12/20/2018 |
TAUNTON, STEPHANIE S | Supervising Prescribing Practitioner | Medical Doctor | 123074 | 09/26/2018 |
THOMAS, ROBERT LOUIS | Supervising Prescribing Practitioner | Osteopathic Physician | 8592 | 09/26/2018 |
WALLACE, MOIRA PETIRS | Supervising Prescribing Practitioner | Medical Doctor | 133941 | 12/20/2018 |
WARD, JILL ANGELA | Supervising Prescribing Practitioner | Medical Doctor | 110689 | 12/20/2018 |
WARRINGTON, STEVEN | Supervising Prescribing Practitioner | Medical Doctor | 131907 | 12/20/2018 |
WHEELER, MARERIL | Supervising Prescribing Practitioner | Medical Doctor | 126534 | 12/20/2018 |
WILSON, ZACHARY WAYNE | Supervising Prescribing Practitioner | Medical Doctor | 117252 | 09/26/2018 |
WINNINGHAM, DAVID JASON | Supervising Prescribing Practitioner | Osteopathic Physician | 12586 | 12/20/2018 |
WRIGHT, GARY DAVID | Supervising Prescribing Practitioner | Medical Doctor | 116465 | 09/26/2018 |
ZAHERI, KAMRAN | Supervising Prescribing Practitioner | Medical Doctor | 136667 | 10/01/2018 |
ZAVORAL, THOMAS WAYNE JR | Supervising Prescribing Practitioner | Medical Doctor | 98270 | 09/26/2018 |
ZEATON, KARIN ELIZABETH | Supervising Prescribing Practitioner | Osteopathic Physician | 10311 | 12/20/2018 |
ZERNIAL, CHRISTOPHER B | Supervising Prescribing Practitioner | Medical Doctor | 131593 | 12/20/2018 |
Click on the License Number to view License Details for that Practitioner
Name | Relationship | Profession | License | Effective Date |
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Click on the License Number to view License Details for that Practitioner
Name | Relationship | Profession | License | Effective Date |
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Click on the License Number to view License Details for that Practitioner
No Continuing Education Hours Received from Approved Providers As Of 12/2/2024
* To find out more about Approved Providers,
or ask a provider why the course you took is not yet listed,
please visit our Continuing Education Providers page.
** 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.
For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.