RICHARD JOHN WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036034790

License Status

NOT RENEWED

Business

First Name

RICHARD JOHN

Last Name

WAGNER

Suffix

Business Name

RICHARD JOHN WAGNER MD

Original Issue Date

08/15/1957

Effective Date

08/15/1957

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006