ERIC D WAGNER Registered Nurse License verification

Business Entity

NOT RENEWED

License Type

Registered Nurse

Description

LICENSED PRACTICAL NURSE

License Number

043109887

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

Last Name

WAGNER

Business Name

ERIC D WAGNER

Original Issue Date

02/23/2010

Effective Date

01/13/2011

Expiration Date

01/31/2013

City

CARBONDALE

State

Zip

62901

County

WILL

Ever Disciplined

LastModifiedDate

03/20/2013