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Next Update: Thursday, December 19, 2024 12:00 PM CST
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GREEN, SUSAN DIANE
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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: |
1145 SOUTH UTICA
SUITE 367
TULSA OK 74104
Address last updated on 2/18/2003 |
| Phone #: |
(918) 579-7791 |
| Fax #: |
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| County: |
TULSA |
| License: |
23230 |
| Dated: |
2/18/2003 |
| Expires: |
2/1/2007 |
| License Type: |
Medical Doctor |
| Specialty: |
Anatomic/Clinical Pathology |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ of TX Med Sch at Houston, Houston Tx 77225 |
| Graduated: |
5 /
1995 |
| CME Year: |
2009 |
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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 PATHOLOGY |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Hillcrest Medical Center
Tulsa, OK
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