THOMAS DEAN HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

THOMAS DEAN

Last Name

HANSEN

Suffix

Business Name

THOMAS DEAN HANSEN MD

Original Issue Date

07/22/1996

Effective Date

07/22/1996

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006