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JOHNSON, DENNIS LARRY       
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: 1403 EAST GRAHAM RANCH TRAIL
PAYSON AZ 85541

Address last updated on 8/31/2009
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 19217
Dated: 10/24/1994
Expires: 10/1/2010
License Type: Medical Doctor
Specialty: Anatomic Pathology
IMMUNOPATHOLOGY
Hematology (Pathology)
Clinical Pathology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Colorado Sch Of Med (frmly in Denver)
Graduated: 12 / 1974
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 - Hematology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1403 EAST GRAHAM RANCH TRAIL
PAYSON AZ 85541

Phone #:
Fax #:
Mon: 6:45AM - 5:00PM
Tue: 6:45AM - 5:00PM
Wed: 6:45AM - 5:00PM
Thu: 6:45AM - 5:00PM
Fri: 6:45AM - 5:00PM
Sat:
Sun:

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