JOHN R WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

JOHN R

Last Name

WAGNER

Suffix

Business Name

JOHN R WAGNER MD

Original Issue Date

09/03/1993

Effective Date

09/03/1993

Expiration Date

07/31/1996

City

PINCKNEYVILLE

State

Zip

62274

County

PERRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006