RICHARD D BASILE JR MD - Medical Doctor License in Indiana | # 125028714

RICHARD D BASILE JR MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028714

License Status

EXPIRED

Business

N

First Name

RICHARD D

Last Name

BASILE JR

Suffix

MD

Business Name

RICHARD D BASILE JR MD

Original Issue Date

06/11/1992

Effective Date

06/11/1992

Expiration Date

06/30/1995

State

IN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006