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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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GREEN, ELLEN LOUISE       
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: P.O. BOX 100
670 PETUNIA ROAD
701 W. MAIN SUITE C
WRIGHT CITY OK 74766-0100

Address last updated on 9/6/2024
Phone #: (580) 236-3705
Fax #:
County: MCCURTAIN
License: 879
Dated: 5/10/1996
Expires: 10/31/2025
License Type: Licensed Dietitian
Specialty:
Status: Active
Status Class: Fully Licensed
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:
P.O. BOX 100
670 PETUNIA ROAD
701 W. MAIN SUITE C
WRIGHT CITY OK 74766-0100

Phone #: (580) 236-3705
Fax #:

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