HILLARY JEAN WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

Title

First Name

HILLARY

Middle

JEAN

Last Name

WAGNER

Business Name

HILLARY JEAN WAGNER MD

Original Issue Date

06/30/2021

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023