KIM E WYATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

KIM

Middle

Last Name

WYATT

Suffix

Business Name

KIM E WYATT MD

Original Issue Date

03/04/2002

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020