BRADLEY W WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043088814

License Status

NOT RENEWED

Business

First Name

BRADLEY

Middle

Last Name

WAGNER

Business Name

BRADLEY W WAGNER

Original Issue Date

09/04/2003

Effective Date

11/16/2004

Expiration Date

01/31/2007

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

07/17/2007