Maryland Board of Physicians
Practitioner Profile Portal
This data was extracted on
9/30/2025
.
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License Number
:
C0008434
Rudy Anthony Lacosse
License Type
:
Physician Assistant
License Status
:
Active
License Issued
:
04/28/2022
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)
University Of Md Charles Regional Medical Center
Umd Baltimore Washington Medical Center
University Of Md Upper Chesapeake Medical Center
Medical Licenses Held in Other States
(as reported by licensee)
Florida
New Jersey
Pennsylvania
Physician Assistant Notification of Collaboration Agreements
Agreement ID: 2288 | Submit Date: 11/26/2024
Practice Setting: Hospital
Facility: Umd Baltimore Washington Medical Center
Address: 301 Hospital Drive
Glen Burnie, MD 21061
Advanced Duties: Yes | Prescriptive Authority: Yes | Dispensing Authority: No
View Collaboration Agreement
Active Supervisee - Delegation Agreement For Core Duties
D0069566
Ivelisse Michel Status: Approved |
Approved Date:
05/31/2022 | Agreement No: 30804
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0083427
David Nathanael Lauver Status: Approved |
Approved Date:
10/28/2022 | Agreement No: 31494
Prescribe CDS: Yes | Non-CDS: No | Medical Devices: No
Dispense CDS: No | Dispense NCDS: No
D0079224
David Griffin Wholey Status: Approved |
Approved Date:
03/13/2024 | Agreement No: 33685
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.
Appendix
General Disclaimer
Glossary of Terms
Notice to Credential Verification Professionals