REID H HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

REID H

Last Name

HANSEN

Suffix

Business Name

REID H HANSEN MD

Original Issue Date

09/02/1982

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021