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Oklahoma Board of Medical Licensure and Supervision

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LEVINE, MARK ELLIOT       
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: VISTA STAFFING SOLUTIONS
675 EAST 2100 SOUTH, SUITE 390
SALT LAKE CITY UT 84106

Address last updated on 8/11/2004
Phone #: (800) 366-1884
Fax #:
County: NOT OKLAHOMA
License: 22734
Dated: 7/2/2002
Expires: 7/1/2003
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ of TX Med Sch at Houston, Houston Tx 77225
Graduated: 6 / 1996
CME Year: 2005
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 FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
VISTA STAFFING SOLUTIONS
675 EAST 2100 SOUTH, SUITE 390
SALT LAKE CITY UT 84106

Phone #: (800) 366-1884
Fax #:

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