License Verification

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License Number: OS9772

Data As Of 5/19/2024

Profession
Osteopathic Physician
License
OS9772
License Status
CLEAR/Active
License Expiration Date
3/31/2026
License Original Issue Date
03/30/2006
Address of Record
555 North Byron Parkway
DMH Family Medicine
PERRY, FL 32347
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
DMH Family Practice 117 SW Virginia Circle
MAYO, FL 32066
Address
ACV Community Services 10820 Marvin Jones Blvd
LIVE OAK, FL 32060
Address
333 North Byron Parkway Doctors Memorial Hospital
PERRY, FL 32348
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 5/19/2024



* 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.