ALEXIS CARROLL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****96

License Status

NOT RENEWED

Business

First Name

ALEXIS

Last Name

CARROLL

Business Name

ALEXIS CARROLL

Original Issue Date

09/26/2019

Effective Date

01/21/2020

Expiration Date

03/01/2022

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022