AMY M WYATT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

ACTIVE

Business

Title

DMD

First Name

AMY

Middle

Last Name

WYATT

Business Name

AMY M WYATT DMD

Original Issue Date

07/18/2006

Effective Date

08/16/2024

Expiration Date

09/30/2027

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/16/2024