License holder summary

DIANE WAGNER is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for DIANE WAGNER is ISLIP NY 11751. This medical practitioner license is not current. The license was granted 06/25/1997 and expired on 12/31/2002.

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

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