LAURA D WYATT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

ACTIVE

Business

First Name

LAURA D

Last Name

WYATT

Business Name

LAURA D WYATT

Original Issue Date

07/29/2004

Effective Date

02/21/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60615

County

COOK

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

12/03/2025