MARY J WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043038170

License Status

NOT RENEWED

Business

First Name

MARY J

Last Name

WAGNER

Business Name

MARY J WAGNER

Original Issue Date

10/17/1975

Effective Date

01/12/2015

Expiration Date

01/31/2017

City

POLO

State

Zip

61064

County

OGLE

Ever Disciplined

LastModifiedDate

03/27/2017