JUSTIN R WAGNER Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012644

License Status

INACTIVE

Business

First Name

JUSTIN

Middle

Last Name

WAGNER

Business Name

JUSTIN R WAGNER

Original Issue Date

09/14/2001

Effective Date

09/14/2001

Expiration Date

09/30/2004

City

BETTENDORF

State

Zip

52722

County

IOWA

Ever Disciplined

LastModifiedDate

09/01/2006