DOVILAN LOGAN WYATT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

Title

First Name

DOVILAN

Middle

LOGAN

Last Name

WYATT

Business Name

DOVILAN LOGAN WYATT MD

Original Issue Date

07/02/2010

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60619

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023