ALAN M WAGNER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051325

License Status

INACTIVE

Business

First Name

ALAN M

Last Name

WAGNER

Suffix

Business Name

ALAN M WAGNER MD

Original Issue Date

07/10/1975

Effective Date

07/23/2008

Expiration Date

07/31/2011

City

WOODWARD

State

Zip

73801

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

04/07/2011