THOMAS HAROLD HANSEN Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003464

License Status

INACTIVE

Business

First Name

THOMAS

Middle

HAROLD

Last Name

HANSEN

Business Name

THOMAS HAROLD HANSEN

Original Issue Date

06/03/2009

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

01/03/2022