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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

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CLARK, ANDREA MICHELLE       
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: COMANCHE COUNTY MEMORIAL HOSPITAL
3401 W GORE BLVD
LAWTON OK 73505

Address last updated on 10/1/2023
Phone #: (580) 355-8620 x3797
Fax #:
County: COMANCHE
License: 2610
Dated: 7/12/2021
Expires: 10/31/2024
Temp. Ltr. Issued: 5/20/2021
Temp. Ltr. Expires: 7/29/2021
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:
COMANCHE COUNTY MEMORIAL HOSPITAL
3401 W GORE BLVD
LAWTON OK 73505

Phone #: (580) 355-8620 x3797
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JULIA ANNE BAHASH PD 856

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