License holder summary

MICHELLE CHRISTINE WAGNER is a Board Of Medicine licensed to practice in Idaho. The address on file for MICHELLE CHRISTINE WAGNER is 388 Kenai Ave Apt H Fort Richardson AK 99505. This licensed professional license is not current. The license was granted 07/09/1996 and expired on 06/30/2000.

Idaho

Division of Occupational and Professional Licenses

MICHELLE CHRISTINE WAGNER
Board Of Medicine
License number
LRT-566
Date granted
07/09/1996
Date expires
06/30/2000
Class
Board Of Medicine
Status
Canceled
Address
388 Kenai Ave Apt H Fort Richardson AK 99505
idaholicensing.com
ID 48334533
LAST UPDATED 2024-03-09 01:15:13 UTC

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