ALEXANDRIA AKEMI CARLYLE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

ACTIVE

Business

Title

DMD

First Name

ALEXANDRIA

Middle

AKEMI

Last Name

CARLYLE

Business Name

ALEXANDRIA AKEMI CARLYLE DMD

Original Issue Date

07/13/2021

Effective Date

08/30/2024

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2024