RICHARD M BASALY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141829

License Status

NOT RENEWED

Business

Title

First Name

RICHARD

Middle

Last Name

BASALY

Business Name

RICHARD M BASALY MD

Original Issue Date

10/11/2016

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

COCOA

State

Zip

32926

Ever Disciplined

LastModifiedDate

01/14/2021