JONATHAN ALLEN WYATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

JONATHAN ALLEN

Last Name

WYATT

Suffix

Business Name

JONATHAN ALLEN WYATT MD

Original Issue Date

01/05/2011

Effective Date

05/19/2011

Expiration Date

07/31/2014

City

HAZEL CREST

State

Zip

60429

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020