JACK D HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044382

License Status

NOT RENEWED

Business

First Name

JACK D

Last Name

HANSEN

Suffix

Business Name

JACK D HANSEN MD

Original Issue Date

07/07/1971

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

DEER PARK

State

Zip

60010

County

LAKE

Ever Disciplined

LastModifiedDate

11/01/2017