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KORNBLUT, ALAN DAVID       
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: 5530 WISCONSIN AVE
#535
CHEVY CHASE MD 20815
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 13628
Dated: 5/17/1982
Expires: 6/30/1986
License Type: Medical Doctor
Specialty: Otolaryngology
Head & Neck Surgery
MAXILLOFACIAL SURGERY
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: WV Univ Sch Of Med, Morgantown Wv 26506
Graduated: 5 / 1967
CME Year:
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF OTOLARYNGOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
5530 WISCONSIN AVE
#535
CHEVY CHASE MD 20815

Phone #:
Fax #:

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