License Verification

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KRISTIN GRIMM ALLISON

License Number: PA9113102

Data As Of 6/3/2024

Profession
Physician Assistant
License
PA9113102
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
03/11/2020
Address of Record
100 Whetstone Place
First Coast Heart and Vascular
Suite 102
ST AUGUSTINE, FL 32086
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
100 Whetstone Place First Coast Heart & Vascular Suite 102
SAINT AUGUSTINE, FL 32086
Address
400 Health Park Blvd Flagler Hospital
SAINT AUGUSTINE, FL 32086
Name Relationship Profession License Effective Date
CARACCIOLO, VINCENT JAMES Supervising Prescribing Practitioner Medical Doctor 90994 05/29/2020
CRISCO, LARRY VAN-THOMAS Supervising Prescribing Practitioner Medical Doctor 115672 05/29/2020
EDWARDS, CHRISTOPHER CLINTON Supervising Prescribing Practitioner Osteopathic Physician 12464 05/29/2020
GRECH, DAVID ROGER Supervising Prescribing Practitioner Medical Doctor 99750 05/29/2020
HAYES, KEVIN MICHAEL Supervising Prescribing Practitioner Osteopathic Physician 10344 06/01/2020
JONES, MICIAH Supervising Prescribing Practitioner Osteopathic Physician 16062 06/01/2020
KAVETI, PUNITA Supervising Prescribing Practitioner Medical Doctor 135249 06/01/2020
KOREN, MICHAEL JAY Supervising Prescribing Practitioner Medical Doctor 60337 06/01/2020
MANDALAKAS, NICHOLAS JOHN Supervising Prescribing Practitioner Medical Doctor 143033 06/01/2020
MARTIN, LILLA GAYLE MD Supervising Prescribing Practitioner Medical Doctor 30921 06/01/2020
PUBBI, DINESH Supervising Prescribing Practitioner Medical Doctor 102037 05/29/2020
SANGHVI, NEIL KISHORE Supervising Prescribing Practitioner Medical Doctor 119157 05/29/2020
SINGH, SUNIL PARTAP Supervising Prescribing Practitioner Medical Doctor 135109 05/29/2020
VEDRE, AMEETH Supervising Prescribing Practitioner Medical Doctor 113851 05/29/2020

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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 6/3/2024



* 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.