MARI JO HANSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****02

License Status

NOT RENEWED

Business

First Name

MARI

Middle

Last Name

HANSON

Business Name

MARI JO HANSON

Original Issue Date

12/17/2021

Effective Date

12/17/2021

Expiration Date

03/01/2024

City

RAYMOND

State

Zip

62560

County

MONTGOMERY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025