A LANE HANSEN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046200

License Status

EXPIRED

Business

First Name

Middle

LANE

Last Name

HANSEN

Suffix

Business Name

A LANE HANSEN DO

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006