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GONZALEZ, ALFONSO       
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: COLUMBIA SKIN CLINIC LLC
THREE MEDICAL PARK SUITE 500
COLUMBIA SC 29203

Address last updated on 5/5/2009
Phone #: (803) 779-7316
Fax #: (803) 343-2511
County: NOT OKLAHOMA
License: 18575
Dated: 7/1/1993
Expires: 7/1/2010
License Type: Medical Doctor
Specialty: Dermatopathology
Anatomic Pathology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: UNIV AUTO DE SAN LUIS POTOSI, FAC DE MED, SAN LUIS POTOSI, MEXICO
Graduated: 5 / 1979
CME Year: 2012
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
AMERICAN BOARD OF PATHOLOGY - Dermatopathology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
COLUMBIA SKIN CLINIC LLC
THREE MEDICAL PARK SUITE 500
COLUMBIA SC 29203

Phone #: (803) 779-7316
Fax #: (803) 343-2511
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
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