JEAN ELIZABETH WAGNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002379

License Status

NOT RENEWED

Business

First Name

JEAN ELIZABETH

Last Name

WAGNER

Business Name

JEAN ELIZABETH WAGNER

Original Issue Date

07/03/1974

Effective Date

07/03/1974

Expiration Date

04/01/1982

City

MIDDLETON

State

Zip

53562

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005