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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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GREEN, MICHAEL DALE       
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: 1616 NORTH VICTORIA PLACE
EDMOND OK 73034
Phone #:
Fax #:
County: OKLAHOMA
License: 18189
Dated: 7/20/1992
Expires: 7/1/1996
Training Issued: 7/1/1992
Training Expires: 9/12/1992
License Type: Medical Doctor
Specialty: Internal Medicine
Cardiovascular Disease
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated: 5 / 1989
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: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1616 NORTH VICTORIA PLACE
EDMOND OK 73034

Phone #:
Fax #:

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