ALAN M WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

ALAN M

Last Name

WAGNER

Suffix

Business Name

ALAN M WAGNER MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60626

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011