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THEOBALD, LARA JOSAN
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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.
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Practice Address: |
5911 W. MEMORIAL RD
SUITE 200
OKLAHOMA CITY OK 73142
Address last updated on 7/31/2023 |
Phone #: |
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Fax #: |
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County: |
OKLAHOMA |
License: |
22010 |
Dated: |
8/22/2001 |
Expires: |
8/1/2025 |
License Type: |
Medical Doctor |
Specialty: |
Internal Medicine
Medical Oncology |
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Status: |
Active |
Status Class: |
Fully Licensed |
Restricted to: |
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Registered to Dispense: |
YES |
Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
Graduated: |
5 /
2000 |
CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Certifications: |
AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Hospice and Palliative Medicine
AMERICAN BOARD OF INTERNAL MEDICINE - Medical Oncology |
New Patients: |
Yes |
Medicaid: |
Yes |
Medicare: |
Yes |
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HMO/PPO: |
None listed |
Hospital Privileges: |
None listed |
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