DUANE DAVID HANSEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137001141

License Status

ACTIVE

Business

First Name

DUANE

Middle

DAVID

Last Name

HANSEN

Business Name

DUANE DAVID HANSEN

Original Issue Date

06/06/2024

Effective Date

06/06/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

09/19/2023