License Verification

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KEIANA LATREECE SKINNER

License Number: PA9113823

Data As Of 5/16/2024

Profession
Physician Assistant
License
PA9113823
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
11/05/2020
Address of Record
7028 Kiwano Way
WINDERMERE, FL 34786
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
7028 Kiwano Way
WINDERMERE, FL 34786
Address
7028 Kiwano Way
WINDERMERE, FL 34786
Name Relationship Profession License Effective Date
BOVELL, DON WALDO MD Supervising Prescribing Practitioner Medical Doctor 81076 04/09/2021
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 08/09/2021

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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 5/16/2024



* 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.