License Search: Details

Name	Title	Specialty	Certified	Primary Practice Location	Licensed Or Has Been Licensed In
Kasey Avis Statum	MD	Pediatrics	Verify Specialty Certification	1302 River Street Palatka, FL (Other)	CT, GA, NY, VA, FL

License History

License Type	License Number	Status	License Date	Expiration Date
PMD	21877	Expired	03/14/2005	6/30/2021
TMP	1375	Expired	01/11/2005	03/14/2005

Education History

School	Date Completed	Nature of Training
Howard University College Of Medicine	12/18/1999	Medical or Podiatric School
Einstein Com Afl Hospital, Bronx	12/19/2002	Post-Graduate Training

Physician Assistant(s) Collaboration

Name
No Current Supervision

Discipline/Board Action History

Discipline/Board Action	Type of Action	Action Date	Public Documents
Yes	Limitation or Restriction on License/Practice	11/09/2009	Consent Order
Yes	Limitation or Restriction on License/Practice	2/7/2011	Consent Order

Malpractice History

No Malpractice Cases On Record

This data was retrieved on 4/17/2026.