Wisconsin
Department of Safety and Professional Services
Basham, Mark C
Medicine And Surgery
License number
40500-20
Date granted
10/23/1998
Date expires
10/31/2015
Class
Medicine And Surgery
Status
Active
wisconsinmedicine.org
ID 12786949
LAST UPDATED 2024-02-19 03:41:12 UTC
LAST UPDATED 2024-02-19 03:41:12 UTC
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