LESLEY L WAGNER Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070011847

License Status

NOT RENEWED

Business

First Name

LESLEY

Middle

Last Name

WAGNER

Business Name

LESLEY L WAGNER

Original Issue Date

03/24/2000

Effective Date

09/27/2018

Expiration Date

09/30/2020

City

GENEVA

State

Zip

60134

County

KANE

Ever Disciplined

LastModifiedDate

01/14/2021