DOROTHEA G WAGNER Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072003732

License Status

CANCELLED

Business

First Name

DOROTHEA G

Last Name

WAGNER

Business Name

DOROTHEA G WAGNER

Original Issue Date

05/24/1988

Expiration Date

09/30/1990

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

09/04/2005