LISA BETH VANWAGNER MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****58

NOT RENEWED

N

LISA

BETH

VANWAGNER

MD

LISA BETH VANWAGNER MD

01/15/2010

05/27/2020

07/31/2023

CHICAGO

IL

60611

COOK

PRACTITIONER

II III IV V

N

11/30/2023