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SAMBAJON, EMILIA TOLIBAS       
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: 1 MILE EAST HWY 270
PO BOX 1-466
FORT SUPPLY OK 73841
Phone #:
Fax #:
County: WOODWARD
License: 21600
Dated: 10/27/1978
Expires: 3/25/2003
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Special License
Restricted to: WSPH OR GLMHC
Registered to Dispense: YES
Medical School: Manila Central Univ, Coll Of Med, Caloocan City, Rizal, Philippines
Graduated: 5 / 1965
CME Year: 2003
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:
1 MILE EAST HWY 270
PO BOX 1-466
FORT SUPPLY OK 73841

Phone #:
Fax #:

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