THOMAS ERIC HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

ERIC

Last Name

HANSEN

Suffix

Business Name

THOMAS ERIC HANSEN MD

Original Issue Date

06/09/2006

Effective Date

05/23/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/10/2011