License Verification

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JESSICA PATRICIA KOFFMAN

License Number: PA9105789

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9105789
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
11/10/2010
Address of Record
2711 Letap Ct
Unit 101
LAND O LAKES, FL 34638
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
18610 Fernview St.
LAND O LAKES, FL 34638
Address
13571 San Juan Diego Way
DOVER, FL 33527
Address
16640 US Highway 301 South
WIMAUMA, FL 33598
Address
14446 N Dale Mabry
TAMPA, FL 33618
Name Relationship Profession License Effective Date
JONES, JOEL Supervising Dispensing Practitioner Osteopathic Physician 19563 03/25/2024
JONES, JOEL Supervising Prescribing Practitioner Osteopathic Physician 19563 03/24/2024
WALDREP, NATHAN KEITH Supervising Dispensing Practitioner Medical Doctor 58834 11/17/2023
WALDREP, NATHAN KEITH Supervising Prescribing Practitioner Medical Doctor 58834 11/17/2023

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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



* 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.