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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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FULLER, KATHERYN J       
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: NORTHEASTERN STATE UNIVERSITY
2400 WEST SHAWNEE ST
MUSKOGEE OK 74401

Address last updated on 10/28/2024
Phone #: (918) 444-2942 x36075
Fax #:
County: OKLAHOMA
License: 1516
Dated: 6/29/2007
Expires: 10/31/2025
Temp. Ltr. Issued: 8/13/2021
Temp. Ltr. Expires: 11/18/2021
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:
NORTHEASTERN STATE UNIVERSITY
2400 WEST SHAWNEE ST
MUSKOGEE OK 74401

Phone #: (918) 444-2942 x36075
Fax #:

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