DONNA LEE WAGNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004901

License Status

NOT RENEWED

Business

First Name

DONNA LEE

Last Name

WAGNER

Business Name

DONNA LEE WAGNER

Original Issue Date

07/22/1982

Effective Date

07/22/1982

Expiration Date

09/30/1986

City

SCHERERVILLELAKE

State

Zip

46375

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005