AILEEN PORTUGAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

ACTIVE

Business

Title

First Name

AILEEN

Last Name

PORTUGAL

Business Name

AILEEN PORTUGAL MD

Original Issue Date

04/29/2025

Effective Date

04/29/2025

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2025