LINDA R WAGNER Perfusionist License verification

Business Entity

NOT RENEWED

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000101

License Status

NOT RENEWED

Business

First Name

LINDA

Middle

Last Name

WAGNER

Business Name

LINDA R WAGNER

Original Issue Date

01/06/2003

Effective Date

02/08/2008

Expiration Date

04/30/2010

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

06/02/2010