RICHARD H WAGNER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027419

License Status

EXPIRED

Business

First Name

RICHARD H

Last Name

WAGNER

Suffix

Business Name

RICHARD H WAGNER MD

Original Issue Date

07/17/1991

Effective Date

07/17/1991

Expiration Date

07/07/1993

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006