DENNIS R WAGNER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

ACTIVE

Business

First Name

DENNIS

Middle

Last Name

WAGNER

Suffix

DMD

Business Name

DENNIS R WAGNER DMD

Original Issue Date

06/12/2007

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62305

County

ADAMS

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024