JOHN MARK WAGNER - Physical Therapist License in Illinois | # 070003107

JOHN MARK WAGNER

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070003107

License Status

NOT RENEWED

Business

N

First Name

JOHN MARK

Last Name

WAGNER

Business Name

JOHN MARK WAGNER

Original Issue Date

12/24/1979

Effective Date

12/24/1979

Expiration Date

08/01/1982

State

IL

Ever Disciplined

N

LastModifiedDate

10/14/2005