DIEDRE ANN WAGERS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054934

License Status

CANCELLED

Business

Title

First Name

DIEDRE

Middle

ANN

Last Name

WAGERS

Business Name

DIEDRE ANN WAGERS MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

04/19/2011