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PORCIONCULA, MARY AILEEN ESQUIVEL       
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: SPARKS MEDICAL FOUNDATION
202 SOUTH POCOLA BLVD
POCOLA OK 74902
Phone #:
Fax #:
County: LEFLORE
License: 20677
Dated: 6/19/1998
Expires: 6/1/2002
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: PHILIPPINE MEDICAL SCHOOLS
Graduated: 3 / 1991
CME Year: 2004
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 FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
SPARKS MEDICAL FOUNDATION
202 SOUTH POCOLA BLVD
POCOLA OK 74902

Phone #:
Fax #:

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