| Name | WAGNER WILLIAM LEVINE |
|---|---|
| Address | LAGUNA BEACHCA |
| Profession | LICENSED MASTER SOCIAL WORK |
| License No | 003929 |
| Date of Licensure | 09/01/04 (OriginallylicensedasaCertifiedSocialWorkeron11/10/67) |
| Additional Qualification | |
| Status | INACTIVE |
| Registered through last day of |