ERMIL D WAGNER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

ACTIVE

Business

First Name

ERMIL D

Last Name

WAGNER

Suffix

Business Name

ERMIL D WAGNER DO

Original Issue Date

05/09/1991

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023