KRISTEN P HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

Last Name

HANSEN

Suffix

Business Name

KRISTEN P HANSEN MD

Original Issue Date

08/13/2004

Effective Date

08/13/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008