ALEXANDRA NICOLE THEISEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036160822

License Status

ACTIVE

Business

Title

First Name

ALEXANDRA

Middle

NICOLE

Last Name

THEISEN

Business Name

ALEXANDRA NICOLE THEISEN MD

Original Issue Date

06/09/2022

Effective Date

07/16/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63108

Ever Disciplined

LastModifiedDate

07/16/2023