MICHAEL ANDREW WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097924

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANDREW

Last Name

WAGNER

Suffix

Business Name

MICHAEL ANDREW WAGNER MD

Original Issue Date

06/05/1998

Effective Date

06/06/2017

Expiration Date

09/30/2020

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2011000076

Action

Reprimand

Discipline Start Date

12/20/2012

Discipline Reason

due to prescribing medication outside the scope of his practice and failing to keep proper medical records.