KURT J WAGNER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014665

License Status

EXPIRED

Business

First Name

KURT J

Last Name

WAGNER

Suffix

Business Name

KURT J WAGNER MD

Original Issue Date

06/30/1982

Effective Date

06/30/1982

Expiration Date

06/23/1984

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006