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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 25, 2024 6:43 PM CST
Next Update: Thursday, December 26, 2024 2:50 AM CST

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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.
Practice Address: 3861 CLIFFSIDE DR
BELLINGHAM WA 98225-8403

Address last updated on 6/2/2021
Phone #: (360) 656-5086
Fax #: (360) 933-4634
County: NOT OKLAHOMA
License: 22614
Dated: 8/15/2001
Expires: 8/1/2022
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1997
CME Year: 2022
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 PSYCHIATRY AND NEUROLOGY (Psychiatry specific)
New Patients: No
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
3861 CLIFFSIDE DR
BELLINGHAM WA 98225-8403

Phone #: (360) 656-5086
Fax #: (360) 933-4634
Mon:
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