BASANTI R VRUSHAB Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039985

License Status

EXPIRED

Business

First Name

BASANTI

Middle

Last Name

VRUSHAB

Business Name

BASANTI R VRUSHAB

Original Issue Date

06/25/1999

Effective Date

06/25/1999

Expiration Date

06/24/2002

City

FARMINGTON

State

Zip

87402

County

NEW MEXICO

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006