DUANE DAVID HANSEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

ACTIVE

Business

First Name

DUANE

Middle

DAVID

Last Name

HANSEN

Business Name

DUANE DAVID HANSEN

Original Issue Date

07/30/1985

Effective Date

07/17/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/17/2024