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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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HANSEN, LORI ELDEAN       
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: 13313 N MERIDIAN
SUITE A-3
OKLAHOMA CITY OK 73120

Address last updated on 6/4/2024
Phone #: (405) 753-9600
Fax #: (405) 753-9601
County: OKLAHOMA
License: 13287
Dated: 7/22/1981
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Facial Plastic Surgery
Otolaryngology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1979
CME Year: 2027
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
7/12/2012 Probation Ended
9/20/2007 Probation
3/9/2006 Surrendered License
1/20/2006 Complaint Citation
11/4/2004 Modification Order
7/18/2002 Probation
1/18/2002 Suspension, License
Board Filings and/or Orders:
07/12/2012
11/03/2011
09/15/2011
07/22/2010
09/20/2007
07/19/2007
03/09/2006
03/09/2006
01/13/2006
01/13/2006
11/12/2004
07/18/2002
01/18/2002
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMER BOARD OF FACIAL PLASTIC/RECONSTRUCTIVE SURGERY - 5/09
AMERICAN BOARD OF OTOLARYNGOLOGY
AMERICAN BOARD OF OTOLARYNGOLOGY - Plastic Surgery Within the Head and Neck
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
13313 N MERIDIAN
SUITE A-3
OKLAHOMA CITY OK 73120

Phone #: (405) 753-9600
Fax #: (405) 753-9601
Mon: 9:00AM - 5:00PM
Tue: 9:00AM - 5:00PM
Wed: 9:00AM - 5:00PM
Thu: 9:00AM - 5:00PM
Fri: 9:00AM - 5:00PM
Sat:
Sun: 9:00AM - 5:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ALEXANDRA BROUSSARD APRN 103887

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