JACQUELYN A WAGNER Speech-Language Pathologist License verification

Business Entity

INACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146008943

License Status

INACTIVE

Business

First Name

JACQUELYN

Middle

Last Name

WAGNER

Business Name

JACQUELYN A WAGNER

Original Issue Date

05/25/2007

Effective Date

10/28/2009

Expiration Date

10/31/2011

City

WAUWATOSA

State

Zip

53226

County

WISCONSIN

Ever Disciplined

LastModifiedDate

08/03/2011