JENNIFER L WAGONER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015942

License Status

ACTIVE

Business

First Name

JENNIFER

Middle

Last Name

WAGONER

Business Name

JENNIFER L WAGONER

BusinessDBA

MS.

Original Issue Date

08/23/2007

Effective Date

09/10/2024

Expiration Date

09/30/2026

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

09/10/2024