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Oklahoma Board of Medical Licensure and Supervision

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SMITH JOHNSEN, DEBRA LYNN       
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: 2915 EAST 102ND STREET
TULSA OK 74137

Address last updated on 7/1/2009
Phone #:
Fax #:
County: TULSA
License: 16977
Dated: 7/1/1989
Expires: 7/1/2009
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduated: 5 / 1988
CME Year: 2009
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: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
2915 EAST 102ND STREET
TULSA OK 74137

Phone #:
Fax #:
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