License holder summary

TERESA ELIZABETH WAGNER is a Board Of Medicine licensed to practice in Idaho. The address on file for TERESA ELIZABETH WAGNER is 913 E Jefferson St Boise ID 83712. This licensed professional license is not current. The license was granted 11/16/1998 and expired on 07/02/1999.

Idaho

Division of Occupational and Professional Licenses

TERESA ELIZABETH WAGNER
Board Of Medicine
License number
M-7635
Date granted
11/16/1998
Date expires
07/02/1999
Class
Board Of Medicine
Status
Canceled
Address
913 E Jefferson St Boise ID 83712
idaholicensing.com
ID 48334538
LAST UPDATED 2024-02-07 14:20:24 UTC

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