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LOFTIN, TERESA DIANE       
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: INNOVAGE PACE
401 W NORTHERN AVE
401 W NORTHERN AVE
PUEBLO CO 81004

Address last updated on 10/4/2024
Phone #: (719) 224-0125
Fax #:
County: NOT OKLAHOMA
License: 22820
Dated: 5/9/2002
Expires: 11/1/2025
License Type: Medical Doctor
Specialty: General Practice
Geriatric Medicine (Family Practice)
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of KS Sch Of Med, Kansas City Ks 66103
Graduated: 5 / 1996
CME Year: 2027
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
1/14/2011 Probation Ended
1/14/2010 Probation
8/5/2009 Complaint Citation
Board Filings and/or Orders:
01/14/2010
07/02/2009
07/02/2009
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
INNOVAGE PACE
401 W NORTHERN AVE
401 W NORTHERN AVE
PUEBLO CO 81004

Phone #: (719) 224-0125
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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