MARK A HANSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060917

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

HANSEN

Suffix

Business Name

MARK A HANSEN MD

Original Issue Date

09/11/1980

Effective Date

09/11/1980

Expiration Date

07/31/1984

City

JEFFERSON

State

Zip

53549

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006