CHARLES GILBERT WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

CHARLES GILBERT

Last Name

WAGNER

Suffix

Business Name

CHARLES GILBERT WAGNER MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006