KURT A WAGNER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000756

License Status

NOT RENEWED

Business

First Name

KURT

Middle

Last Name

WAGNER

Suffix

DDS

Business Name

KURT A WAGNER DDS

Original Issue Date

07/16/2009

Effective Date

08/23/2018

Expiration Date

01/31/2022

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/09/2022