STEPHEN PAUL WAGNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

ACTIVE

Business

Title

First Name

STEPHEN

Middle

PAUL

Last Name

WAGNER

Business Name

STEPHEN PAUL WAGNER MD

Original Issue Date

04/11/2018

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

MUKWONAGO

State

Zip

53149

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023