ANTHONY CHARLES WAGNER - Occupational Therapist License in Wisconsin | # 056006368

ANTHONY CHARLES WAGNER

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006368

License Status

NOT RENEWED

Business

N

First Name

ANTHONY

Middle

CHARLES

Last Name

WAGNER

Business Name

ANTHONY CHARLES WAGNER

Original Issue Date

11/14/2001

Effective Date

10/08/2009

Expiration Date

12/31/2011

State

WI

Ever Disciplined

N

LastModifiedDate

02/08/2012