ROBERT HEWITT 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

ROBERT HEWITT

Last Name

WAGNER

Suffix

Business Name

ROBERT HEWITT WAGNER MD

Original Issue Date

01/01/1997

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/13/2023