KELVIN EARL WYNN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

First Name

KELVIN

Middle

EARL

Last Name

WYNN

Business Name

KELVIN EARL WYNN

Original Issue Date

03/28/2007

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023