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HERSCHEL, MARK KELLAND       
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: 1516 JEFFERSON HIGHWAY
JEFFERSON LA 70121
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 17111
Dated: 9/22/1989
Expires: 6/30/1990
Temp. Lic. Issued: 8/24/1987
Temp. Lic. Expires: 9/30/1988
License Type: Medical Doctor
Specialty: Ophthalmology
Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1987
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:
1516 JEFFERSON HIGHWAY
JEFFERSON LA 70121

Phone #:
Fax #:

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