TIMOTHY J WAGNER - Physical Therapist License in Wisconsin | # 070015254

TIMOTHY J WAGNER

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015254

License Status

INACTIVE

Business

N

First Name

TIMOTHY

Middle

J

Last Name

WAGNER

Business Name

TIMOTHY J WAGNER

Original Issue Date

08/22/2006

Effective Date

08/02/2010

Expiration Date

09/30/2012

State

WI

Ever Disciplined

N

LastModifiedDate

07/05/2012