ALEXA PITTS SOULT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

Title

First Name

ALEXA

Middle

PITTS

Last Name

SOULT

Business Name

ALEXA PITTS SOULT MD

Original Issue Date

08/07/2019

Effective Date

08/07/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021