RONALD G WAGNER JR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026813

License Status

EXPIRED

Business

First Name

RONALD G

Last Name

WAGNER JR

Suffix

Business Name

RONALD G WAGNER JR MD

Original Issue Date

05/17/1991

Effective Date

05/17/1991

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006