BETH A HAGEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

ACTIVE

Business

First Name

BETH

Middle

Last Name

HAGEN

Business Name

BETH A HAGEN

Original Issue Date

07/06/2016

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024