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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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COOPER-HORNE, ELISE ROSE       
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: DAVITA - REDBIRD SMITH DIALYSIS
305 S JT STITES ST
SALLISAW OK 74955-9302

Address last updated on 9/3/2024
Phone #: (918) 235-0290
Fax #: (918) 235-0351
County: SEQUOYAH
License: 1480
Dated: 11/2/2006
Expires: 10/31/2025
Temp. Ltr. Issued: 10/19/2006
Temp. Ltr. Expires: 11/4/2006
License Type: Licensed Dietitian
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:
DAVITA - REDBIRD SMITH DIALYSIS
305 S JT STITES ST
SALLISAW OK 74955-9302

Phone #: (918) 235-0290
Fax #: (918) 235-0351

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