RUSSELL, RENNY BEAU - Licensee Information

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RUSSELL, RENNY BEAU

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 73034-5207 Address last updated on 7/11/2011
Phone #:	(405) 974-2959 x2959
Fax #:
County:	OKLAHOMA
License:	541
Dated:	9/15/2011
Expires:	8/31/2012
Temp. Ltr. Issued:	8/9/2011
Temp. Ltr. Expires:	9/16/2011
License Type:	Apprentice Athletic Trainer
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	0

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 73034-5207 Phone #: (405) 974-2959 x2959 Fax #:

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