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MUSALLAM, L. SAM       
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: 4400 N.W. 63RD
OKLAHOMA CITY OK 73116

Address last updated on 5/29/2018
Phone #: (405) 673-7722
Fax #: (405) 673-7723
County: OKLAHOMA
License: 11815
Dated: 7/1/1978
Expires: 11/25/2018
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1977
CME Year: 2021
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
10/2/2008 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:
08/02/2013
11/06/2008
10/02/2008
10/02/2008
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:
4400 N.W. 63RD
OKLAHOMA CITY OK 73116

Phone #: (405) 673-7722
Fax #: (405) 673-7723

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