ANTHONY CHARLES WAGNER Occupational Therapist License verification

Business Entity

NOT RENEWED

License Type

Occupational Therapist

Description

OCCUPATIONAL THERAPIST

License Number

056006368

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

CHARLES

Last Name

WAGNER

Business Name

ANTHONY CHARLES WAGNER

Original Issue Date

11/14/2001

Effective Date

10/08/2009

Expiration Date

12/31/2011

City

HARTLAND

State

Zip

53029

County

WISCONSIN

Ever Disciplined

LastModifiedDate

02/08/2012