JEFF L WAGNER Physical Therapist License verification

Business Entity

ACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST ASSISTANT

License Number

160002214

License Status

ACTIVE

Business

First Name

JEFF L

Last Name

WAGNER

Business Name

JEFF L WAGNER

Original Issue Date

09/06/1995

Effective Date

09/05/2025

Expiration Date

09/30/2027

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

09/05/2025