License Verification

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KRISTINA DANIELA MCCOLGAN

License Number: PA9111580

Data As Of 5/16/2024

Profession
Physician Assistant
License
PA9111580
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/12/2018
Address of Record
2776 Cleveland Ave
FT MYERS, FL 33901
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
9981 S. Healthpark Dr.
FORT MYERS, FL 33908
Address
23450 Via Coconut Point
ESTERO, FL 33928
Address
13681 Doctors Way
FT MYERS, FL 33912
Name Relationship Profession License Effective Date
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 01/05/2021
HENDRIX, TIMOTHY WAYNE Supervising Prescribing Practitioner Medical Doctor 65142 11/24/2020

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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 5/17/2024



* 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.