AMANDA L WAGNER DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****69

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

WAGNER

Suffix

DVM

Business Name

AMANDA L WAGNER DVM

Original Issue Date

12/15/2004

Effective Date

11/21/2006

Expiration Date

01/31/2009

City

AROMA PARK

State

Zip

60910

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2009