CHRISTIAN E WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

CHRISTIAN E

Last Name

WAGNER

Suffix

Business Name

CHRISTIAN E WAGNER MD

Original Issue Date

02/02/1996

Effective Date

04/22/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/22/2023