CHRISTINA R WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

First Name

CHRISTINA

Middle

Last Name

WAGNER

Suffix

Business Name

CHRISTINA R WAGNER MD

Original Issue Date

10/03/2008

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2023