License holder summary

KELLY LYNN WAGNER is a Temporary Physical Therapist licensed to practice in Pennsylvania. The address on file for KELLY LYNN WAGNER is Tamaqua PA 18252. This licensed professional license is not current. The license was granted 01/05/2004 and expired on 07/05/2004.

Pennsylvania

Department of State

KELLY LYNN WAGNER
Temporary Physical Therapist
License number
TPT019739
Date granted
01/05/2004
Date expires
07/05/2004
Class
Temporary Physical Therapist
Status
Voided
Address
Tamaqua PA 18252
palicensing.org
ID 17331643
LAST UPDATED 2024-04-30 23:57:44 UTC

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