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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Thursday, December 19, 2024 2:50 AM CST

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THEODORE, ALEXANDER       
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: Not Currently Practicing
SALT LAKE CITY UT 84117

Address last updated on 4/26/2013
Phone #: (801) 261-2060
Fax #:
County: NOT OKLAHOMA
License: 11907
Dated: 8/11/1978
Expires: 8/30/2007
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Disciplinary Action
Restricted to:
Registered to Dispense: NO
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduated: 12 / 1974
CME Year: 2009
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
11/1/2007 Surrendered License
8/30/2007 Suspension, License
7/21/2005 Probation
Board Filings and/or Orders:
11/01/2007
10/24/2007
08/30/2007
08/30/2007
08/30/2007
07/21/2005
03/31/2005
03/31/2005
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:
Not Currently Practicing
SALT LAKE CITY UT 84117

Phone #: (801) 261-2060
Fax #:
Spanish

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