License Number: MM36997Data As Of 11/14/2018
|License Expiration Date||8/31/2019|
|License Original Issue Date||08/31/2017|
|Address of Record||476 Highway A1A|
|SATELLITE BEACH, FL 32937|
|Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)||No|
|Discipline on File||No|
The information on this page is a secure, primary source for license verification provided by the Florida Department of Health, Division of Medical Quality Assurance. This website is maintained by Division staff and is updated immediately upon a change to our licensing and enforcement database.