MYRON WILLIAM WAGNER DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019008409

License Status

INACTIVE

Business

First Name

MYRON WILLIAM

Last Name

WAGNER

Suffix

DDS

Business Name

MYRON WILLIAM WAGNER DDS

Original Issue Date

04/26/1943

Effective Date

04/26/1943

Expiration Date

09/30/1990

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/12/2005