License Verification

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CHANDLER NICOLE KRACHT

License Number: PA9111892

Data As Of 6/6/2024

Profession
Physician Assistant
License
PA9111892
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/26/2018
Address of Record
12902 USF Magnolia Dr
Moffitt Cancer Center
TAMPA, FL 33612
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
12902 USF Magnolia Dr Moffitt Cancer Center
TAMPA, FL 33612
Name Relationship Profession License Effective Date
KEERTY, DINESH Supervising Prescribing Practitioner Medical Doctor 124796 03/14/2022
LYONS, LANCE BRADFORD Supervising Prescribing Practitioner Physician Assistant 9105357 11/15/2021
MEHTA, RUTIKA Supervising Prescribing Practitioner Medical Doctor 133135 02/20/2022
OTT, PAUL CARL Supervising Prescribing Practitioner Osteopathic Physician 18168 10/25/2021
STROSBERG, JONATHAN RAPHAEL Supervising Prescribing Practitioner Medical Doctor 87326 04/01/2022
XIE, HAO Supervising Prescribing Practitioner Medical Doctor 144384 03/26/2022

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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 6/6/2024



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** 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.


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