BASIL DUANE FOSSUM
Department Of Health - Medical Doctor
Florida ME53505 Active
This Florida license is held by BASIL DUANE FOSSUM. The license is currently active. It was granted on 01/01/1973 and expired on 01/31/2015
LICENSE DETAILS
- License Number: ME53505
- Category: Medical Doctor
- Status: Active
- Date Granted: 01/01/1973 (over 52 years ago)
- Expiry Date: 01/31/2015 (over 10 years ago)
LOCATIONS
A Primary Practice Address
914 B MAR WALT DR, FORT WALTON BEACH, FL 32547
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