KIMBERLY ANN WYATT Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

ANN

Last Name

WYATT

Business Name

KIMBERLY ANN WYATT

Original Issue Date

12/23/2019

Effective Date

12/09/2025

Expiration Date

03/01/2028

City

AVON

State

Zip

44011

County

OHIO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/09/2025