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ICOCHEA, ROSENDO SEGUNDO       
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: 5 VINE LANE
PO BOX 157
GRANITE SPRINGS NY 10527-0157
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 16712
Dated: 11/10/1988
Expires: 11/1/1996
License Type: Medical Doctor
Specialty: Plastic Surgery
General Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF HI J A BURNS SCH MED, HONOLULU HI 96822
Graduated: 5 / 1976
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
5 VINE LANE
PO BOX 157
GRANITE SPRINGS NY 10527-0157

Phone #:
Fax #:

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