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RUSNACK, DOUGLAS WILLIAM
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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: |
12 EDGEWOOD ROAD
ST. LOUIS MO 63124
Address last updated on 3/20/2012 |
| Phone #: |
(917) 477-7351 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
23807 |
| Dated: |
4/14/2004 |
| Expires: |
4/1/2013 |
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Temp.
Lic.
Issued:
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2/4/2004 |
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Temp.
Lic.
Expires:
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5/22/2004 |
| License Type: |
Medical Doctor |
| Specialty: |
Diagnostic Radiology |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032 |
| Graduated: |
5 /
1998 |
| CME Year: |
2013 |
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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 RADIOLOGY |
| New Patients: |
No |
| Medicaid: |
No |
| Medicare: |
No |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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