License NumberC0002345 Sandra Kaupang Forti
License TypePhysician Assistant
License StatusActive    
License Issued11/03/2000  License Expiration:  6/30/2025

Licensure Pathway:   Traditional
Special License Category:   N/A
Public Address
No Public Address Available
 Medical Assistance

Accept Medicaid? N/A

 Maryland Hospital Privilege Information (as reported by licensee)

Licensee has not reported Maryland Hospital Privilege information for the profile site.
 Medical Licenses Held in Other States (as reported by licensee)

Virginia
 Physician Assistant Notification of Collaboration Agreements

Collaboration Agreements have not been reported for the profile site.
 Active Supervisee - Delegation Agreement For Core Duties

D0070109  Esteban Schabelman   Status: Approved |  Approved Date: 03/24/2021 | Agreement No: 21619
Prescribe CDS: No | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: Yes
 Known Disciplinary Actions by any state medical board (within the past 10 years)

In Maryland:

No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.

Other States:

No Known Disciplinary Actions by any other state medical board have been reported.
 Download all Maryland Disciplinary Actions

All Orders are downloaded in .pdf format.
None.
 Pending Charges  Please Read Disclaimer

All Charges are downloaded in .pdf format.
None.
 Other Public Actions in the Practice of the Profession or Administrative Fines (including Maryland)  Please Read Description

No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.

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