HOLM, GREGORY ALAN - Licensee Information

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HOLM, GREGORY ALAN

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:	SOUTHWESTERN OKLAHOMA STATE UNIVERSITY 100 CAMPUS DRIVE WEATHERFORD OK 73096-3098 Address last updated on 8/27/2002
Phone #:	(580) 774-3072
Fax #:
County:	CUSTER
License:	285
Dated:	3/6/2001
Expires:	8/31/2005
Temp. Ltr. Issued:	1/18/2001
Temp. Ltr. Expires:	3/17/2001
License Type:	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:
SOUTHWESTERN OKLAHOMA STATE UNIVERSITY 100 CAMPUS DRIVE WEATHERFORD OK 73096-3098 Phone #: (580) 774-3072 Fax #:

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