THOMAS J WAGNER - Nursing Home Administrator License in Wisconsin | # 044002775

THOMAS J WAGNER

Business Entity

NOT RENEWED

License Type

Nursing Home Administrator

Description

LICENSED NURSING HOME ADMINISTRATOR

License Number

044002775

License Status

NOT RENEWED

Business

N

First Name

THOMAS

Middle

J

Last Name

WAGNER

Business Name

THOMAS J WAGNER

Original Issue Date

07/07/1983

Effective Date

12/01/2007

Expiration Date

11/30/2009

State

WI

Ever Disciplined

N

LastModifiedDate

01/07/2010