DANIEL ROTH HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036048

License Status

NOT RENEWED

Business

First Name

DANIEL ROTH

Last Name

HANSEN

Suffix

Business Name

DANIEL ROTH HANSEN MD

Original Issue Date

09/02/1959

Effective Date

09/02/1959

Expiration Date

07/31/1987

City

WALWORTH

State

Zip

53184

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006