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ZUJKO, RICHARD DAVID
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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: |
2138 N KANSAS AVE
LIBERAL KS 67901-2012
Address last updated on 1/25/2002 |
| Phone #: |
(620) 624-8360 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
17580 |
| Dated: |
2/1/1991 |
| Expires: |
2/1/2004 |
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Temp.
Lic.
Issued:
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11/1/1990 |
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Temp.
Lic.
Expires:
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3/1/1992 |
| License Type: |
Medical Doctor |
| Specialty: |
Otolaryngology
Head & Neck Surgery |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Wayne State Univ SOM, Detroit Mi 48201 |
| Graduated: |
5 /
1969 |
| CME Year: |
2004 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 7/29/2004 |
Revoked License |
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Board Filings and/or Orders:
07/29/2004
06/03/2004
06/03/2004
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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 OTOLARYNGOLOGY |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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