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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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CONWAY, TARA DIANE       
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: 2822 TREECE CIRCLE NE
PIEDMONT OK 73078

Address last updated on 10/19/2024
Phone #: (405) 833-3542
Fax #: (405) 373-3498
County: CANADIAN
License: 1187
Dated: 11/8/2001
Expires: 10/31/2025
Temp. Ltr. Issued: 9/20/2001
Temp. Ltr. Expires: 11/10/2001
License Type: Licensed Dietitian
Specialty:
Status: Active
Status Class: Fully Licensed
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:
2822 TREECE CIRCLE NE
PIEDMONT OK 73078

Phone #: (405) 833-3542
Fax #: (405) 373-3498
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KAYLEE NICOLE TYSON PD 786

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