MARISA R WAGNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015957

License Status

NOT RENEWED

Business

First Name

MARISA

Middle

Last Name

WAGNER

Business Name

MARISA R WAGNER

Original Issue Date

08/14/2017

Effective Date

10/25/2021

Expiration Date

09/30/2024

City

MILWAUKEE

State

Zip

53219

Ever Disciplined

LastModifiedDate

02/04/2025