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PELLETIER, GLENN JEFFREY       
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: NEMOURS CARDIAC CENTER
A.I.DUPONT HOSPITAL FOR CHILDREN
1600 ROCKLAND ROAD
WILMINGTON DE 19803-3607

Address last updated on 9/1/2014
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 23598
Dated: 9/11/2003
Expires: 9/1/2015
Temp. Lic. Issued: 6/20/2003
Temp. Lic. Expires: 7/19/2003
License Type: Medical Doctor
Specialty: SURGERY, THORACIC
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Dartmouth Med, Hanover Nh 03755
Graduated: 6 / 1991
CME Year: 2015
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 THORACIC SURGERY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
NEMOURS CARDIAC CENTER
A.I.DUPONT HOSPITAL FOR CHILDREN
1600 ROCKLAND ROAD
WILMINGTON DE 19803-3607

Phone #:
Fax #:
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