RACHEL FAITH HANSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068454

License Status

CANCELLED

Business

Title

First Name

RACHEL

Middle

FAITH

Last Name

HANSEN

Business Name

RACHEL FAITH HANSEN MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

11/02/2019

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/28/2019