License Verification

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MOUDAR ALSHAZLEY

License Number: ME78728

Data As Of 6/2/2024

Profession
Medical Doctor
License
ME78728
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
08/06/1999
Address of Record
6002 BERRYHILL ROAD
MILTON, FL 32570
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
DENNISON, CHARLTON PAIGE Supervisor Medical Doctor 121535 05/13/2021

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Name Relationship Profession License Effective Date
AMBROSE, JESSICA Prescribing Physician Assistant Physician Assistant 9110160 2/21/2017
ATHEARN, CHERYL PARKER Prescribing Physician Assistant Physician Assistant 9107831 9/24/2018
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 1/8/2020
BUCK, JENNIFER FRANCES Prescribing Physician Assistant Physician Assistant 9106346 1/8/2020
CRAWFORD, JIMMIE CONRAD Prescribing Physician Assistant Physician Assistant 9104289 9/23/2016
FOWLER JR, TIMOTHY DALE Prescribing Physician Assistant Physician Assistant 9110560 11/15/2017
KEETON, PATRICK RAY Prescribing Physician Assistant Physician Assistant 9107121 2/7/2019
LEGALL, INGRID Subordinate Medical Doctor 78455 3/1/2019
MIXON, KEELY NICOLE Prescribing Physician Assistant Physician Assistant 9110923 3/23/2018
WILKERSON, BENNY RAY JR Prescribing Physician Assistant Physician Assistant 9102065 10/28/2016

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 6/2/2024



* 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.