DANE CHRISTIAN HANSEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

Title

First Name

DANE

Middle

CHRISTIAN

Last Name

HANSEN

Business Name

DANE CHRISTIAN HANSEN DO

Original Issue Date

01/15/2015

Effective Date

01/15/2015

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017