DIANNE B WAGNER Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****81

License Status

NOT RENEWED

Business

First Name

DIANNE

Middle

Last Name

WAGNER

Business Name

DIANNE B WAGNER

Original Issue Date

07/26/2001

Effective Date

07/26/2001

Expiration Date

05/31/2004

City

ALTAMONT

State

Zip

62411

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

10/09/2006