ANDREW J WAGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

Title

First Name

ANDREW

Middle

Last Name

WAGNER

Business Name

ANDREW J WAGNER MD

Original Issue Date

03/06/2012

Effective Date

03/06/2012

Expiration Date

07/31/2014

City

CANTON

State

Zip

44718

County

OHIO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020