SABRINA M WAGNER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

SABRINA

Middle

Last Name

WAGNER

Business Name

SABRINA M WAGNER

Original Issue Date

03/15/2007

Effective Date

03/15/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008