License holder summary

WAGNER LEROY R is a Pharmacy - Designated Representative (Exemptees) licensed to practice in California. The address on file for WAGNER LEROY R is 4500 CAMPUS DRIVE #115 NEWPORT BEACH CA 92660. This licensed professional license is not current. The license was granted 06/23/1987 and expired on 01/01/2000.

California

Department of Consumer Affairs

WAGNER LEROY R
Pharmacy - Designated Representative (Exemptees)
License number
1294
Date granted
06/23/1987
Date expires
01/01/2000
Class
Pharmacy - Designated Representative (Exemptees)
Status
Canceled
Address
4500 CAMPUS DRIVE #115 NEWPORT BEACH CA 92660
californialicensing.org
ID 11669479
LAST UPDATED 2024-02-27 07:15:39 UTC

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