License holder summary

IDA JANELLE WAGNER is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for IDA JANELLE WAGNER is Philadelphia PA 19144. This medical practitioner license is not current. The license was granted 05/12/2005 and expired on 06/17/2011.

Department of State

Board of Medicine

IDA JANELLE WAGNER
Graduate Medical Trainee
License number
MT186202
Date granted
05/12/2005
Date expires
06/17/2011
Class
Graduate Medical Trainee
Status
Inactive
Address
Philadelphia PA 19144
medicinepa.com
ID 37577017
LAST UPDATED 2024-02-28 02:30:36 UTC

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