STEPHEN W WAGNER JR Advanced Practice Nurse License verification

Business Entity

INACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209000775

License Status

INACTIVE

Business

First Name

STEPHEN

Middle

Last Name

WAGNER

Suffix

Business Name

STEPHEN W WAGNER JR

Original Issue Date

06/08/2001

Effective Date

04/06/2020

Expiration Date

08/31/2022

City

LAND O' LAKES

State

Zip

34639

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/02/2022