CHRISTOPHER SCOTT WAGONER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

First Name

CHRISTOPHER

Middle

SCOTT

Last Name

WAGONER

Suffix

Business Name

CHRISTOPHER SCOTT WAGONER MD

Original Issue Date

03/09/2010

Effective Date

07/28/2023

Expiration Date

07/31/2026

City

GODFREY

State

Zip

62035

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/28/2023