KIMBERLY NICOLE MALAVOLTI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008133

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

NICOLE

Last Name

MALAVOLTI

Business Name

KIMBERLY NICOLE MALAVOLTI

Original Issue Date

01/15/2021

Effective Date

01/12/2026

Expiration Date

03/01/2028

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/12/2026