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Next Update: Thursday, December 19, 2024 2:50 AM CST
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JORDAN-WAGNER, DIANE LYNN
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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: |
1739 NORTH 4TH STREET
TERRE HAUTE IN 47804
Address last updated on 12/6/2002 |
| Phone #: |
(812) 235-3027 x317 |
| Fax #: |
(812) 232-0930 |
| County: |
NOT OKLAHOMA |
| License: |
15644 |
| Dated: |
3/20/1986 |
| Expires: |
3/1/2006 |
| License Type: |
Medical Doctor |
| Specialty: |
Allergy & Immunology
Aerospace Medicine
Pediatrics |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
MED COLL OF PA, PHILADELPHIA PA 19129 |
| Graduated: |
5 /
1982 |
| CME Year: |
2007 |
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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 ALLERGY AND IMMUNOLOGY
AMERICAN BOARD OF PEDIATRICS |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna PPO
CIGNA PPO |
| Hospital Privileges: |
Hospital(s) Not In Oklahoma
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