Maryland Board of Physicians
Practitioner Profile Portal
This data was extracted on
9/30/2025
.
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License Number
:
C0003057
Kristen M. Lopez
License Type
:
Physician Assistant
License Status
:
Active
License Issued
:
12/07/2004
License Expiration:
06/30/2027
Licensure Pathway:
Traditional
Special License Category:
N/A
Education
N/A
Medical Assistance
Accept Medicaid?
N/A
Maryland Hospital Privilege Information
(as reported by licensee)
Medstar Southern Maryland Hospital Center
Medical Licenses Held in Other States
(as reported by licensee)
District of Columbia
Virginia
Physician Assistant Notification of Collaboration Agreements
Agreement ID: 5403 | Submit Date: 05/29/2025
Practice Setting: Telemedicine
Facility: MedStar E-visit
Address: 10960 Grantchester Way
Columbia, MD 21044
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No
View Collaboration Agreement
Active Supervisee - Delegation Agreement For Core Duties
H0080072
Elise Danielle Worley Status: Approved |
Approved Date:
10/22/2021 | Agreement No: 22924
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0038543
Kevin Henry Scruggs Status: Approved |
Approved Date:
10/22/2021 | Agreement No: 22930
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0065897
Daniel Dabbah Status: Approved |
Approved Date:
08/29/2024 | Agreement No: 34839
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
Download all Maryland Disciplinary Actions
(not time-limited)
All Orders are downloaded in .pdf format.
None.
Summary of Known Disciplinary Actions by any state medical board
(within the past 10 years)
Please Read Description
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.
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.
Convictions for any crime involving moral turpitude
None reported by the courts.
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General Disclaimer
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Notice to Credential Verification Professionals