KENNETH D HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065635

License Status

NOT RENEWED

Business

First Name

KENNETH D

Last Name

HANSEN

Suffix

Business Name

KENNETH D HANSEN MD

Original Issue Date

11/09/1982

Effective Date

11/09/1982

Expiration Date

07/31/1987

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/20/2006