License holder summary

KELLY JOHANNA WAGGENER is a Dentist licensed to practice in Pennsylvania. The address on file for KELLY JOHANNA WAGGENER is Santa Rosa CA 95409. This medical practitioner license is not current. The license was granted 08/16/2000 and expired on 06/30/2005.

Department of State

Board of Medicine

KELLY JOHANNA WAGGENER
Dentist
License number
DS031388L
Date granted
08/16/2000
Date expires
06/30/2005
Class
Dentist
Status
Expired
Address
Santa Rosa CA 95409
medicinepa.com
ID 37440252
LAST UPDATED 2024-05-17 20:23:40 UTC

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