Ac#847623O STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE LICENSE NO. CONTROL NO. 07/20/2018 142503 The DENTIST named below has met all requirements of the laws and rules of the state of Florida. Expiration Date: FEBRUARY 28, 2020 KARYNA SHULIAK 6100 RED HOOK QUARTERS SUITE B-3 ST THOMAS, VI 00802 Rick Scott Celeste M. Philip, M.D.. M.P.H. GOVERNOR Surgeon General and Secretary DISPLAY IF REQUIRED BY LAW rn C\I CD tczt CO La 8 vi Io QQJ O O Ea w O I-- W z w o < • w 0 5 CONTROL NO. LICENSE NO. w 0 in N O KARYNA SHULIAK EXPIRATION DATE: FEBRUARY 28, 2020 Your license number is DN 21635. Please use it In all correspondence with your board/council. Each licensee is solely responsible for notifying the Department in writing of the licensee's current mailing address and practice location address. If you have not received your renewal notice 90 days prior to the expiration date shown on this license, please visit www.FLHealthSource.govand click "Renew ALicense" to renew online. Medical Quality Assurance has a new and improved Online Services Portal. In the new system, you have the ability to renew your license, update your mailing and practice location addresses, request a name change, request a duplicate license and update your profile Information all from the convenience of your online account. 1. Go to www.FLHealthSource.gov. 2. Click on 'Provider Services' and select "Manage Your License." 3. Select your profession and license type and click "Submit." 4. The question 'Have you Registered in Our New Online Service System?" will display. a. Click on 'No" if you have not registered for an account in the new system and follow the instructions provided for new user registration. b. Click on "Yes* if you are a returning user. Enter the user ID and password you selected during the registration process, then select 'Sign In" to access your MQAOnline Services Portal account. IMPORTANT ANNOUNCEMENTS Are You Renewal Ready? The Department of Health will now review your continuing education records at the time of license renewal. To learn more, please visit www.FLHealthSource.gov/AYRR Grounds for Discipline You should be familiar with the Grounds for Discipline found in Section 456.072(1), Florida Statutes, and in the practice act for the profession in which you are licensed. 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