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Oklahoma Board of Medical Licensure and Supervision

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QUEVILLON, MELISSA NAOMI       
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: LOGAN CO HOSPITAL
205 S ACADEMY
GUTHRIE OK 73044

Address last updated on 6/20/2001
Phone #: (405) 282-5125
Fax #:
County: LOGAN
License: 20776
Dated: 7/20/1998
Expires: 7/1/2004
Training Issued: 7/1/1997
Training Expires: 8/1/1998
License Type: Medical Doctor
Specialty: MEDICINE/PEDIATRICS
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated: 6 / 1997
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 INTERNAL MEDICINE
AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
LOGAN CO HOSPITAL
205 S ACADEMY
GUTHRIE OK 73044

Phone #: (405) 282-5125
Fax #:

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