Gender: M

Race: C

Birth Date: 07/28/1930

Death Date: 05/28/1961

Place of Birth: Carroll, IA

Year Medical License Issued: 1961

Medical School: State Univ. of Iowa Medical

Medical School Location: IA

Degree: MD

Graduation Date: 1955

References:

Certified by TX Board?: Y

Location: Fort Worth

Specialty:

Secondary Specialty:

Notes: