License holder summary

K. Thomas Wagner, Jr., M.D. is a Radiology - Radiation Facility Medical licensed to practice in Indiana. The address on file for K. Thomas Wagner, Jr., M.D. is 101 Marilyn Avenue, Suite 6, Goshen IN 46526-4800. This licensed professional license is not current. The license was granted 01/19/2007 and expired on 01/19/2010.

Indiana

Professional Licensing Agency

K. Thomas Wagner, Jr., M.D.
Radiology - Radiation Facility Medical
License number
XF201241
Date granted
01/19/2007
Date expires
01/19/2010
Class
Radiology - Radiation Facility Medical
Status
Expired
Address
101 Marilyn Avenue, Suite 6, Goshen IN 46526-4800
indianalicensing.org
ID 24942300
LAST UPDATED 2024-02-10 16:01:32 UTC

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