Department of State
Board of Medicine
DIANE WAGNER
Medical Physician And Surgeon
License number
MD062671L
Date granted
06/25/1997
Date expires
12/31/2002
Class
Medical Physician And Surgeon
Status
Inactive
Address
ISLIP NY 11751
medicinepa.com
ID 37689550
LAST UPDATED 2024-01-07 18:16:59 UTC
LAST UPDATED 2024-01-07 18:16:59 UTC
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