PHILIP I WAGNER MD - Medical Doctor License in Oregon | # 036042682

PHILIP I WAGNER MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042682

License Status

NOT RENEWED

Business

N

First Name

PHILIP I

Last Name

WAGNER

Suffix

MD

Business Name

PHILIP I WAGNER MD

Original Issue Date

07/11/1969

Effective Date

07/11/1969

Expiration Date

07/01/1982

State

OR

Ever Disciplined

N

LastModifiedDate

09/20/2006