MARIAN JUDE WAGNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002739

License Status

NOT RENEWED

Business

First Name

MARIAN JUDE

Last Name

WAGNER

Business Name

MARIAN JUDE WAGNER

Original Issue Date

10/23/1975

Effective Date

09/05/2018

Expiration Date

01/31/2022

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/09/2022