RONALD G WAGNER JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

RONALD G

Last Name

WAGNER JR

Suffix

Business Name

RONALD G WAGNER JR MD

Original Issue Date

10/03/1994

Effective Date

10/03/1994

Expiration Date

07/31/1999

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006