GENEVIEVE A WAGNER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070017303

License Status

ACTIVE

Business

First Name

GENEVIEVE

Middle

Last Name

WAGNER

Business Name

GENEVIEVE A WAGNER

Original Issue Date

08/06/2009

Effective Date

09/06/2024

Expiration Date

09/30/2026

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/06/2024