CHRISTINA ELENA PORTAL CLARKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

CHRISTINA

Middle

ELENA PORTAL

Last Name

CLARKE

Business Name

CHRISTINA ELENA PORTAL CLARKE MD

Original Issue Date

06/01/2017

Effective Date

06/01/2017

Expiration Date

09/30/2020

City

MT PLEASANT

State

Zip

29464

County

SOUTH CAROLINA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021