CHRISTINA R WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

CHRISTINA

Middle

Last Name

WAGNER

Suffix

Business Name

CHRISTINA R WAGNER MD

Original Issue Date

10/15/2002

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

CARMI

State

Zip

62821

County

WHITE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2023