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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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MIXON, KIMBERLEE RENEE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: No Current Practice Address
Address last updated on 11/5/2018
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 1288
Dated: 9/23/2004
Expires: 11/5/2018
Temp. Ltr. Issued: 8/23/2004
Temp. Ltr. Expires: 9/23/2004
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Disciplinary Action
Restricted to:
CME Year: 2023
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
11/5/2018 Surrendered License
6/15/2018 Complaint Citation
11/19/2014 Probation Ended
7/25/2013 Modification Order
11/4/2010 Modification Order
11/19/2009 Probation
11/6/2008 Revoked License
6/2/2008 Complaint Citation
5/17/2007 Probation
2/9/2007 Complaint Citation
9/21/2006 Probation
8/24/2006 Complaint Citation
Board Filings and/or Orders:
11/05/2018
06/15/2018
06/15/2018
08/02/2013
11/04/2010
11/19/2009
11/06/2008
06/02/2008
06/02/2008
05/17/2007
02/08/2007
02/08/2007
09/21/2006
08/24/2006
08/24/2006
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
No Current Practice Address
Phone #:
Fax #:

Hospital Privileges:

None listed

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