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Oklahoma Board of Medical Licensure and Supervision

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BOURNE, NATALIE NICOLE       
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: ST. JOHN SIEGFRIED HEALTH CLUB
1819 E 19TH ST
TULSA OK 74104

Address last updated on 3/17/2017
Phone #: (918) 744-3392
Fax #: (918) 744-2610
County: TULSA
License: 1885
Dated: 11/1/2012
Expires: 10/31/2017
Temp. Ltr. Issued: 8/3/2012
Temp. Ltr. Expires: 11/9/2012
License Type: Licensed Dietitian
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:
ST. JOHN SIEGFRIED HEALTH CLUB
1819 E 19TH ST
TULSA OK 74104

Phone #: (918) 744-3392
Fax #: (918) 744-2610

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