KIMBERLY ELISE PORTALE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

KIMBERLY

Middle

ELISE

Last Name

PORTALE

Business Name

KIMBERLY ELISE PORTALE DO

Original Issue Date

07/14/2024

Effective Date

07/14/2024

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026