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HICKS, LISA BOUDREAUX       
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: DELTA NUTRITION PROGRAM
707 KING PLACE
DUNCAN OK 73533
Phone #:
Fax #:
County: STEPHENS
License: 72
Dated: 11/3/1984
Expires: 10/31/1996
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:
DELTA NUTRITION PROGRAM
707 KING PLACE
DUNCAN OK 73533

Phone #:
Fax #:

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