WYATT DALE BAXTER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005627

License Status

ACTIVE

Business

First Name

WYATT

Middle

DALE

Last Name

BAXTER

Business Name

WYATT DALE BAXTER

Original Issue Date

09/08/2015

Effective Date

12/05/2025

Expiration Date

03/01/2028

City

TENNESSEE

State

Zip

62374

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

12/05/2025