License Verification

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KIMBERLY ANN VONDERLIETH

License Number: PA9101648

Data As Of 11/1/2026

Profession
Physician Assistant
License
PA9101648
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2028
License Original Issue Date
07/13/2001
Address of Record
1251 Hickory Street
MELBOURNE, FL 32901
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
FRYE, BRANDON DANIEL Supervising Prescribing Practitioner Osteopathic Physician 13191 10/22/2026
HENSEL, KURT SAMUEL MD Supervising Prescribing Practitioner Medical Doctor 98989 10/22/2026
HICKERSON, LINDSAY ELLIS Supervising Prescribing Practitioner Medical Doctor 140535 10/22/2026
KOVAL, KENNETH JOSEPH Supervising Prescribing Practitioner Medical Doctor 109050 10/22/2026
MOBLEY, KYLE Supervising Prescribing Practitioner Medical Doctor 144693 10/22/2026
PALSIS, JOHN ANDREW Supervising Prescribing Practitioner Medical Doctor 140064 10/22/2026
SEGINA, DANIEL NICK MD Supervising Prescribing Practitioner Medical Doctor 78748 10/22/2026
STEPHENS, BRENT COREY Supervising Prescribing Practitioner Medical Doctor 119690 10/22/2026

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/1/2026



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.