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Oklahoma Board of Medical Licensure and Supervision

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CONNOLLY, BRENDON RAYMOND       
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: 4301 MOW-WAY RD.
FORT SILL OK 73503
Phone #: (580) 458-2695
Fax #:
County: COMANCHE
License: 23484
Dated: 6/27/2003
Expires: 6/1/2007
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: U of Miami L M Miller, SOM, Miami, FL 33101
Graduated: 5 / 1997
CME Year: 2009
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:
New Patients: Yes
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: Reynolds Army Community Hospital
Fort Sill, OK
Locations: Hours: Languages:
4301 MOW-WAY RD.
FORT SILL OK 73503

Phone #: (580) 458-2695
Fax #:
Mon: 7:30AM - 4:30PM
Tue: 7:30AM - 4:30PM
Wed: 7:30AM - 4:30PM
Thu: 7:30AM - 4:30PM
Fri: 7:30AM - 4:30PM

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