| | Physician Last Name: | Blank |
| | Physician First Name: | William |
| | Physician Middle Name: | |
| | Address: | 310 South Crouse Avenue
Suite 203
Syracuse, New York 13210 |
| | License Number: | 148813 |
| | License Type: | MD |
| | Year of Birth: |
1950
|
| | Effective Date: | 04/01/1999 |
| | Action Description for DOH Webpage: | Censure and reprimand and $1,000 fine.The physician has satisfied the terms of the order. |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charge of making or filing a false report. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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