WYATT DANNER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076536

License Status

EXPIRED

Business

Title

First Name

WYATT

Last Name

DANNER

Business Name

WYATT DANNER DO

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

COLUMBIA

State

Zip

62236

County

MONROE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/06/2024