ANDREW CHARLES WAGNER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067171

License Status

EXPIRED

Business

Title

First Name

ANDREW

Middle

CHARLES

Last Name

WAGNER

Business Name

ANDREW CHARLES WAGNER MD

Original Issue Date

06/23/2015

Effective Date

06/23/2015

Expiration Date

06/22/2016

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

08/16/2016