WILLIAM WALLACE BASHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059262

License Status

NOT RENEWED

Business

First Name

WILLIAM WALLACE

Last Name

BASHAM

Suffix

Business Name

WILLIAM WALLACE BASHAM MD

Original Issue Date

09/06/1979

Effective Date

09/06/1979

Expiration Date

07/31/1987

City

SILVER SPRING

State

Zip

20910

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/20/2006