BOSTROM, JAKE PAUL - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

BOSTROM, JAKE PAUL

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:	SOUTHERN EYE ASSOCIATES 104 SIMPSON ST GREENVILLE SC 29605 Address last updated on 7/13/2010
Phone #:	(864) 269-3333
Fax #:
County:	NOT OKLAHOMA
License:	24456
Dated:	9/21/2006
Expires:	9/1/2011
License Type:	Medical Doctor
Specialty:	Ophthalmology

Status:	Inactive
Status Class:	Expired License
Restricted to:
Registered to Dispense:	NO
Medical School:	UNIV OF TN, HLTH SCI CTR, COLL OF MED, MEMPHIS TN 38163
Graduated:	5 / 2005
CME Year:	2012

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:	Contact licensee
Medicaid:	Contact licensee
Medicare:	Contact licensee

HMO/PPO:	None listed
Hospital Privileges:	None listed

Locations:	Hours:	Languages:
SOUTHERN EYE ASSOCIATES 104 SIMPSON ST GREENVILLE SC 29605 Phone #: (864) 269-3333 Fax #:	Mon: 8:00AM - 5:00PM Tue: 8:00AM - 5:00PM Wed: 8:00AM - 5:00PM Thu: 8:00AM - 5:00PM Fri: 8:00AM - 5:00PM Sat: Sun:

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