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MADRIGAL-DERSCH, JULIETTE MICHELLE       
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: 7217 EAST 55TH PLACE
TULSA OK 74145
Phone #:
Fax #:
County: TULSA
License: 20791
Dated: 7/20/1998
Expires: 7/1/2001
Training Issued: 7/1/1997
Training Expires: 8/1/1998
License Type: Medical Doctor
Specialty: Pediatrics
Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: TX A & M UNIV SYS HSC, COLL OF MED, COLLEGE STATION TX 77843
Graduated: 6 / 1997
CME Year: 2001
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
7217 EAST 55TH PLACE
TULSA OK 74145

Phone #:
Fax #:

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