LARRY R WAGNER Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002098

License Status

NOT RENEWED

Business

First Name

LARRY R

Last Name

WAGNER

Business Name

LARRY R WAGNER

Original Issue Date

06/02/1952

Effective Date

06/02/1952

Expiration Date

07/01/1982

City

PALOS HILLS

State

Zip

60465

County

COOK

Ever Disciplined

LastModifiedDate

09/25/2006