License holder summary

Basil Duane Fossum is a Medical - Physician licensed to practice in Colorado. The address on file for Basil Duane Fossum is 914-b Marwalt Dr, Fort Walton Beach, FL, 32547-2547. This licensed professional license is not current. The license was granted 04/09/1981 and expired on 04/30/2015.

Colorado

Division of Professions and Occupations

Basil Duane Fossum
Medical - Physician
License number
23733
Date granted
04/09/1981
Date expires
04/30/2015
Class
Medical - Physician
Status
Inactive
Address
914-b Marwalt Dr, Fort Walton Beach, FL, 32547-2547
coloradolicensing.org
ID 27454846
LAST UPDATED 2024-05-02 10:19:15 UTC

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