BRANDON JAMES WYNN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049385

License Status

CANCELLED

Business

First Name

BRANDON

Middle

JAMES

Last Name

WYNN

Suffix

Business Name

BRANDON JAMES WYNN DO

Original Issue Date

06/25/2005

Effective Date

06/25/2005

Expiration Date

06/24/2008

City

EVANSVILLE

State

Zip

47725

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006