License Verification

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PETER GABRIEL KIMBALL

License Number: PA9112110

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA9112110
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
03/29/2019
Address of Record
4500 San Pablo Road
JACKSONVILLE, FL 32224
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
BESTE, RACHELLE MARIE Supervising Prescribing Practitioner Medical Doctor 122722 05/01/2024
GRAHAM, CHARLES GREGORY Supervising Prescribing Practitioner Medical Doctor 97744 01/18/2023
JAMES, COURTNEY LYN Supervising Prescribing Practitioner Medical Doctor 154037 05/01/2024
KAMINSKI, ANN MD Supervising Prescribing Practitioner Medical Doctor 113696 05/01/2024
MCKENNA, RYAN TIMOTHY Supervising Prescribing Practitioner Osteopathic Physician 13229 05/01/2024
PRUDEN, KATHRYN VIETA Supervising Prescribing Practitioner Medical Doctor 81331 05/01/2024
RIES, JAMES Supervising Dispensing Practitioner Osteopathic Physician 14269 10/24/2020
RIES, JAMES Supervising Prescribing Practitioner Osteopathic Physician 14269 10/24/2020
ST CLAIR IV, JESSE WALTON Supervising Prescribing Practitioner Medical Doctor 142610 05/01/2024

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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 12/23/2024



* 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.