GLENN ALLAN HANSEN DDS - Dentist License in Illinois | # 021000738

GLENN ALLAN HANSEN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000738

License Status

NOT RENEWED

Business

N

First Name

GLENN ALLAN

Last Name

HANSEN

Suffix

DDS

Business Name

GLENN ALLAN HANSEN DDS

Original Issue Date

12/13/1972

Effective Date

12/13/1972

Expiration Date

09/30/2002

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/17/2005