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Next Update: Thursday, December 19, 2024 2:50 AM CST
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JACKSON, EDGAR BASIL
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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.
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| Practice Address: |
W142N7967 THORNDELL DR
MENOMONEE FALLS WI 53051
Address last updated on 9/23/2002 |
| Phone #: |
(262) 251-2124 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
13453 |
| Dated: |
11/17/1981 |
| Expires: |
11/1/2005 |
| License Type: |
Medical Doctor |
| Specialty: |
Psychiatry
Child and Adolescent Psychiatry
Psychoanalysis |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
The Queens Univ Of Belfast, Fac Med, Belfast (918-01 Eff 1/71) |
| Graduated: |
12 /
1957 |
| CME Year: |
2006 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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