ALEXA BERGREN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

ACTIVE

Business

Title

DDS

First Name

ALEXA

Last Name

BERGREN

Business Name

ALEXA BERGREN DDS

Original Issue Date

08/24/2023

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

09/17/2024