TIMOTHY J WAGNER Physical Therapist License verification

Business Entity

INACTIVE

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070015254

License Status

INACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

WAGNER

Business Name

TIMOTHY J WAGNER

Original Issue Date

08/22/2006

Effective Date

08/02/2010

Expiration Date

09/30/2012

City

WAUWATOSA

State

Zip

53226

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/05/2012