DOROTHEA G WAGNER Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071003732

License Status

NOT RENEWED

Business

First Name

DOROTHEA G

Last Name

WAGNER

Business Name

DOROTHEA G WAGNER

Original Issue Date

05/24/1988

Effective Date

07/13/2006

Expiration Date

09/30/2008

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

11/06/2008