GLEN TIMOTHY HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142075

License Status

NOT RENEWED

Business

Title

First Name

GLEN

Middle

TIMOTHY

Last Name

HANSEN

Business Name

GLEN TIMOTHY HANSEN MD

Original Issue Date

12/07/2016

Effective Date

07/10/2018

Expiration Date

09/30/2020

City

CHAGRIN FALLS

State

Zip

44023

County

OHIO

Ever Disciplined

LastModifiedDate

01/14/2021