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Oklahoma Board of Medical Licensure and Supervision

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GONZAGA, MARS BALDOZA       
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: No Current Practice Address
OK
Address last updated on 9/30/2015
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 11062
Dated: 11/8/1976
Expires: 11/1/2018
License Type: Medical Doctor
Specialty: General Surgery
General Practice
Status: Inactive
Status Class: Deceased
Restricted to: Written Agreement
Registered to Dispense: NO
Medical School: Manila Central Univ, Coll Of Med, Caloocan City, Rizal, Philippines
Graduated: 3 / 1961
CME Year: 2018
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
8/18/2009 Complaint Citation
8/22/2006 Complaint Citation
#1/1/1900# Past Disciplinary Action
#1/1/1900# Past Disciplinary Action
#1/1/1900# Past Disciplinary Action
Board Filings and/or Orders:
03/07/2013
09/17/2009
08/17/2009
08/17/2009
03/22/2007
08/21/2006
08/21/2006
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
No Current Practice Address
OK
Phone #:
Fax #: 		Spanish

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