LISA BETH VANWAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124551

License Status

NOT RENEWED

Business

First Name

LISA

Middle

BETH

Last Name

VANWAGNER

Suffix

Business Name

LISA BETH VANWAGNER MD

Original Issue Date

10/28/2009

Effective Date

05/27/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023