BASIL S WALDBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057813

License Status

NOT RENEWED

Business

First Name

BASIL S

Last Name

WALDBAUM

Suffix

Business Name

BASIL S WALDBAUM MD

Original Issue Date

09/15/1978

Effective Date

09/15/1978

City

UNIVERSITY HEIGHTS

State

Zip

44118

County

OHIO

Ever Disciplined

LastModifiedDate

09/20/2006