License holder summary

WAGNER JACK is a Medicine (Physician, Including M Ds & D Os) licensed to practice in New York. The address on file for WAGNER JACK is NEW ROCHELLE NY. This doctor license is not current. The license was granted 07/16/1963.

New York

Office of the Professions

WAGNER JACK
Medicine (Physician, Including M Ds & D Os)
License number
090773
Date granted
07/16/1963
Class
Medicine (Physician, Including M Ds & D Os)
Status
Inactive
Address
NEW ROCHELLE NY
nymedicine.org
ID 30304681
LAST UPDATED 2026-04-03 13:14:28 UTC

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