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GRANT, SOPHIA RACQUEL       
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: UNIVERSITY OF OKLAHOMA HSC
DEPT OF PEDIATRICS
2829 S SHERIDAN RD
TULSA OK 74129-1045

Address last updated on 2/3/2010
Phone #: (918) 831-4599
Fax #: (918) 831-4579
County: TULSA
License: 24883
Dated: 3/17/2006
Expires: 3/1/2011
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Meharry Med Coll Sch Of Med, Nashville Tn 37208
Graduated: 12 / 1993
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: AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
UNIVERSITY OF OKLAHOMA HSC
DEPT OF PEDIATRICS
2829 S SHERIDAN RD
TULSA OK 74129-1045

Phone #: (918) 831-4599
Fax #: (918) 831-4579

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