RANDY D HASSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

RANDY

Middle

Last Name

HASSEN

Business Name

RANDY D HASSEN

Original Issue Date

11/25/1992

Effective Date

11/25/1992

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006