License holder summary

LEANN DAWN VAN WAGNER is a Board Of Medicine licensed to practice in Idaho. The address on file for LEANN DAWN VAN WAGNER is 1600 AVENUE E APT 39 BILLINGS MT 59102. This licensed professional license is not current. The license was granted 01/28/2005 and expired on 06/30/2005.

Idaho

Division of Occupational and Professional Licenses

LEANN DAWN VAN WAGNER
Board Of Medicine
License number
LRT-1090
Date granted
01/28/2005
Date expires
06/30/2005
Class
Board Of Medicine
Status
Canceled
Address
1600 AVENUE E APT 39 BILLINGS MT 59102
idaholicensing.com
ID 48334510
LAST UPDATED 2024-03-30 07:34:33 UTC

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