ERMIL D WAGNER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023104

License Status

EXPIRED

Business

First Name

ERMIL D

Last Name

WAGNER

Suffix

Business Name

ERMIL D WAGNER DO

Original Issue Date

08/12/1988

Effective Date

08/12/1988

Expiration Date

08/15/1991

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006