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Oklahoma Board of Medical Licensure and Supervision

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CHAVEZ, JESSE DYLYN       
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: OU FAMILY MEDICINE
900 NE 10TH STREET
OKLAHOMA CITY OK 73104-5420

Address last updated on 8/4/2015
Phone #: (405) 271-4311
Fax #:
County: OKLAHOMA
License: 722
Dated: 9/13/2012
Expires: 8/31/2015
Temp. Ltr. Issued: 7/26/2012
Temp. Ltr. Expires: 9/14/2012
License Type: 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:
OU FAMILY MEDICINE
900 NE 10TH STREET
OKLAHOMA CITY OK 73104-5420

Phone #: (405) 271-4311
Fax #:

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