Kellie Breanne Wagner
ExpiredIllinois license 020012861
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 020012861
- Status
- Expired (Not Renewed)
- First issued
- June 17, 2009
- Expired
- September 30, 2015
- License holder
- Kellie Breanne Wagner
- Entity type
- Individual
Classifications
- Registered Dental Hygienist Dental
More from the license record
- Current term began
- 08/14/2012
Contact
Chicago, IL 60614
Cook County