MARK EDWARD HANSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

MARK EDWARD

Last Name

HANSEN

Suffix

Business Name

MARK EDWARD HANSEN MD

Original Issue Date

01/01/1997

Effective Date

05/28/2023

Expiration Date

07/31/2026

City

SHERMAN

State

Zip

62684

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/28/2023