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Next Update: Thursday, December 19, 2024 2:50 AM CST

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THEOBALD, LARA JOSAN       
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: 5911 W. MEMORIAL RD
SUITE 200
OKLAHOMA CITY OK 73142

Address last updated on 7/31/2023
Phone #:
Fax #:
County: OKLAHOMA
License: 22010
Dated: 8/22/2001
Expires: 8/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Medical Oncology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2000
CME Year: 2025
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 INTERNAL MEDICINE - Hospice and Palliative Medicine
AMERICAN BOARD OF INTERNAL MEDICINE - Medical Oncology
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
5911 W. MEMORIAL RD
SUITE 200
OKLAHOMA CITY OK 73142

Phone #:
Fax #:
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