Gender: M

Race: C

Birth Date: 01/25/1930

Death Date: 02/04/1963

Place of Birth: Fort Worth, TX

Year Medical License Issued: 1955

Medical School: Univ. TX Medical Branch, Galveston

Medical School Location: TX

Degree: MD

Graduation Date: 1955

References: Obit: TSJM 59:377, Apr., 1963. Port. (dob 1/26/30)

File water-damaged.

Certified by TX Board?: Y

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