ALEXANDRA ELISABETH THIEL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****71

License Status

ACTIVE

Business

First Name

ALEXANDRA

Middle

ELISABETH

Last Name

THIEL

Business Name

ALEXANDRA ELISABETH THIEL

Original Issue Date

05/24/2022

Effective Date

12/06/2025

Expiration Date

03/01/2028

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/06/2025