KRISTINE WAGNER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

ACTIVE

Business

First Name

KRISTINE

Last Name

WAGNER

Business Name

KRISTINE WAGNER

Original Issue Date

10/23/2025

Effective Date

10/23/2025

Expiration Date

03/01/2026

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025