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Oklahoma Board of Medical Licensure and Supervision

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MOSES, SHANE RONALD       
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: NATIONAL FOOT SPECIALIST
2117 N BEECH AVE
BROKEN ARROW OK 74012

Address last updated on 3/9/2006
Phone #: (918) 626-0010
Fax #:
County: TULSA
License: 76
Dated: 3/9/2006
Expires: 1/31/2007
Temp. Ltr. Issued: 1/5/2006
Temp. Ltr. Expires: 3/11/2006
License Type: Licensed Pedorthist
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:
NATIONAL FOOT SPECIALIST
2117 N BEECH AVE
BROKEN ARROW OK 74012

Phone #: (918) 626-0010
Fax #:

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