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Oklahoma Board of Medical Licensure and Supervision

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WELLS, STEPHANIE WIMAN       
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: 4411 W GORE BVD STE A2
LAWTON OK 73505-5977

Address last updated on 9/28/2001
Phone #:
Fax #:
County: COMANCHE
License: 20722
Dated: 10/2/1998
Expires: 10/1/2002
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Raymond & Ruth Perelman Sch of Med at Univ of PA, Philadelphia, PA
Graduated: 5 / 1994
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:
4411 W GORE BVD STE A2
LAWTON OK 73505-5977

Phone #:
Fax #:

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