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Next Update: Thursday, December 19, 2024 2:50 AM CST
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KETTERL, PETRA JASMIN
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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: |
No Current Practice Address
Address last updated on 12/27/2016 |
| Phone #: |
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| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
23747 |
| Dated: |
1/13/2004 |
| Expires: |
1/1/2017 |
| License Type: |
Medical Doctor |
| Specialty: |
Medical Oncology
Internal Medicine |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
E TN STATE UNIV J H QUILLEN COLL OF MED, JOHNSON CITY TN 37614 |
| Graduated: |
5 /
1990 |
| CME Year: |
2019 |
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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 INTERNAL MEDICINE |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
HealthChoice
Railroad Medicare |
| Hospital Privileges: |
Hillcrest Medical Center
Tulsa, OK
Southwestern Regional Medical Center
Tulsa, OK
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| Locations: |
Hours: |
Languages: |
No Current Practice Address
Phone #:
Fax #:
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