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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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JOHNSON, SIMONNE CHANTAL       
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: OSOI
13401 W WESTERN # 301
OKLAHOMA CITY OK 73114

Address last updated on 7/15/2024
Phone #: (405) 218-2530
Fax #:
County: OKLAHOMA
License: 1299
Dated: 9/1/2022
Expires: 8/31/2025
Temp. Ltr. Issued: 7/28/2022
Temp. Ltr. Expires: 9/15/2022
License Type: Athletic Trainer
Specialty:
Status: Active
Status Class: Fully Licensed
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:
OSOI
13401 W WESTERN # 301
OKLAHOMA CITY OK 73114

Phone #: (405) 218-2530
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
SEETHAL RAO MADHAVARAPU MD 23053

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