ROBERT HEWITT WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051902

License Status

ACTIVE

Business

First Name

ROBERT HEWITT

Last Name

WAGNER

Suffix

Business Name

ROBERT HEWITT WAGNER MD

Original Issue Date

09/12/1975

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

05/09/2023