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DE JONG, DAVID CORNELIUS       
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: 550 WEST SHORE LANE
WICHITA KS 67209
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 17584
Dated: 2/2/1991
Expires: 2/1/2001
Temp. Lic. Issued: 1/3/1991
Temp. Lic. Expires: 7/1/1991
License Type: Medical Doctor
Specialty: General Practice
Clinical Pathology
Anatomic/Clinical Pathology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduated: 6 / 1959
CME Year: 2001
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: AMERICAN BOARD OF PATHOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
550 WEST SHORE LANE
WICHITA KS 67209

Phone #:
Fax #:

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