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Oklahoma Board of Medical Licensure and Supervision

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BERGMAN, ALICIA ANN       
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: OKLAHOMA STATE DEPT OF HEALTH
2401 NW 23RD #70
OKLAHOMA CITY OK 73107-2475

Address last updated on 10/4/2017
Phone #: (405) 271-4676
Fax #:
County: OKLAHOMA
License: 460
Dated: 4/26/1986
Expires: 10/31/2018
License Type: Licensed Dietitian
Specialty:
Status: Inactive
Status Class: Expired License
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:
OKLAHOMA STATE DEPT OF HEALTH
2401 NW 23RD #70
OKLAHOMA CITY OK 73107-2475

Phone #: (405) 271-4676
Fax #:

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