BRANDON JAMES WYNN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

ACTIVE

Business

First Name

BRANDON

Middle

JAMES

Last Name

WYNN

Suffix

Business Name

BRANDON JAMES WYNN DO

Original Issue Date

06/06/2008

Effective Date

07/09/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/09/2023