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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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AGUILLARD, BERNARD BLAKE
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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.
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| Practice Address: |
OKLAHOMA SURGICAL HOSPITAL
2408 E 81ST STREET
TULSA OK 74137
Address last updated on 8/21/2024 |
| Phone #: |
(918) 246-9500 |
| Fax #: |
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| County: |
TULSA |
| License: |
418 |
| Dated: |
2/25/2005 |
| Expires: |
8/31/2025 |
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Temp.
Ltr.
Issued:
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9/30/2004 |
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Temp.
Ltr.
Expires:
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3/12/2005 |
| License Type: |
Athletic Trainer |
| Specialty: |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| CME Year: |
2009 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Primary Supervisor(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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RALPH TYLER BOONE
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MD |
18846 |
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