JOHN MATHESON WAGNER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075694

License Status

CANCELLED

Business

Title

First Name

JOHN

Middle

MATHESON

Last Name

WAGNER

Business Name

JOHN MATHESON WAGNER MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/20/2020