LYNNE ILENE WAGNER Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071005890

License Status

NOT RENEWED

Business

First Name

LYNNE

Middle

ILENE

Last Name

WAGNER

Business Name

LYNNE ILENE WAGNER

Original Issue Date

05/27/1999

Effective Date

09/16/2016

Expiration Date

09/30/2018

City

WINSTON SALEM

State

Zip

27106

County

COOK

Ever Disciplined

LastModifiedDate

12/05/2018