New Mexico
Regulation & Licensing Department
Keith Basham, PA-C
Controlled Substance
License number
CS00217313
Date granted
12/06/2011
Date expires
07/31/2014
Class
Controlled Substance
Status
Active
licensingnm.com
ID 5824100
LAST UPDATED 2024-04-25 22:42:08 UTC
LAST UPDATED 2024-04-25 22:42:08 UTC
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