MARK CHRISTOPHER HANSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049511

License Status

CANCELLED

Business

First Name

MARK

Middle

CHRISTOPHER

Last Name

HANSEN

Suffix

Business Name

MARK CHRISTOPHER HANSEN MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CHARLESTON

State

Zip

29492

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006