DAVID T WYATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

WYATT

Suffix

Business Name

DAVID T WYATT MD

Original Issue Date

04/23/1998

Effective Date

04/23/1998

Expiration Date

07/31/2005

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006