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Licensing details for: PTL 13140

Name: Monk-Pruden, Mia Michelle

License Type: Postgraduate Training License

Primary Status: License Canceled Primary Status Definition

School Name: American University of Antigua College of Medicine (Antigua Campus)

Graduation Year: 2023

Previous Names: Monk, Mia Michelle MONK-PRUDEN, MIA MICHELLE

Current Enrolled Postgraduate Training Program

Facility Name: HCA Healthcare Riverside Program

City: Riverside

State: California

Speciality: Family medicine

Start Date: 07/01/2023

Anticipated End Date: 09/30/2025

Address of Record

4445 Magnolia Ave
RIVERSIDE CA 92501-4135
RIVERSIDE county
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Issuance Date

December 5, 2023

Expiration Date

N/A

Current Date / Time

May 24, 2026
9:04:49 AM

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License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Postgraduate Training License

Related Party Role: Physician & Surgeon

Name: Monk-Pruden, Mia Michelle

License/Registration Type: Physician's and Surgeon's

License Number: 207876 Primary Status: License Renewed & Current

Address :
4510 Brockton Ave
RIVERSIDE CA 92501-4015
RIVERSIDE COUNTY

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