Basil Duane Fossum
Medical - Physician
Colorado 23733 Inactive
This Colorado license was held by Basil Duane Fossum. The license is no longer active. It was granted on 04/09/1981 and expired on 04/30/2015
LICENSE DETAILS
- License Number: 23733
- Category: Physician
- Status: Inactive
- Date Granted: 04/09/1981 (about 43 years ago)
- Expiry Date: 04/30/2015 (almost 9 years ago)
LOCATIONS
A Address
914-b Marwalt Dr, Fort Walton Beach, FL, 32547-2547