THOMAS R WAGNER DDS - Dentist License in Illinois | # 019013938

THOMAS R WAGNER DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013938

License Status

NOT RENEWED

Business

N

First Name

THOMAS R

Last Name

WAGNER

Suffix

DDS

Business Name

THOMAS R WAGNER DDS

Original Issue Date

07/07/1970

Effective Date

10/01/2006

Expiration Date

09/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

01/08/2010