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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Thursday, December 19, 2024 12:00 PM CST

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BRIDGES, JACK LARCHE       
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: 10432 NW 16TH
YUKON OK 73099
Phone #:
Fax #:
County: CANADIAN
License: 16944
Dated: 7/1/1989
Expires: 6/30/1993
Training Issued: 6/13/1988
Training Expires: 9/30/1989
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: UNIV OF MO, COLUMBIA SCH OF MED, COLUMBIA MO 65212
Graduated: 5 / 1988
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:
10432 NW 16TH
YUKON OK 73099

Phone #:
Fax #:

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