CHRISTOPHER SCOTT WAGONER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053112

License Status

EXPIRED

Business

First Name

CHRISTOPHER

Middle

SCOTT

Last Name

WAGONER

Suffix

Business Name

CHRISTOPHER SCOTT WAGONER MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

GODFREY

State

Zip

62035

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/08/2010