NINA DELANEY WAGNER-JOHNSTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045752

License Status

CANCELLED

Business

First Name

NINA

Middle

DELANEY

Last Name

WAGNER-JOHNSTON

Suffix

Business Name

NINA DELANEY WAGNER-JOHNSTON MD

Original Issue Date

04/29/2003

Effective Date

04/29/2003

Expiration Date

06/23/2006

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006