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MODAHL, LUCY ELIZABETH       
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: 2 MARLBOROUGHT ST.
MR. EDEN 1024

Address last updated on 9/28/2012
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 24888
Dated: 4/19/2006
Expires: 4/1/2013
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Keck Sch of Med of the USC, LOS ANGELES CA 90089
Graduated: 5 / 2001
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 RADIOLOGY
New Patients: Yes
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: Hospital(s) Not In Oklahoma
,
Oklahoma Heart Hospital - North Campus (4050 W. Memorial Rd)
Oklahoma City, OK
Locations: Hours: Languages:
2 MARLBOROUGHT ST.
MR. EDEN 1024

Phone #:
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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