GOODWIN, RICHARD BLAKE - Licensee Information

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GOODWIN, RICHARD BLAKE

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:	UNIVERSITY OF CENTRAL OKLAHOMA 100 NORTH UNIVERSITY DRIVE EDMOND OK 73013 Address last updated on 4/3/2001
Phone #:
Fax #:
County:	OKLAHOMA
License:	282
Dated:	5/3/2001
Expires:	8/31/2002
Temp. Ltr. Issued:	4/5/2001
Temp. Ltr. Expires:	7/21/2001
License Type:	Apprentice Athletic Trainer
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
UNIVERSITY OF CENTRAL OKLAHOMA 100 NORTH UNIVERSITY DRIVE EDMOND OK 73013 Phone #: Fax #:

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