THOMAS R WAGNER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013938

License Status

NOT RENEWED

Business

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

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/08/2010