ROY MARSHALL WAGNER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036164627

License Status

ACTIVE

Business

Title

First Name

ROY

Middle

MARSHALL

Last Name

WAGNER

Business Name

ROY MARSHALL WAGNER DO

Original Issue Date

05/08/2023

Effective Date

05/08/2023

Expiration Date

07/31/2026

City

O'FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/08/2023