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OLSON, CLINTON BURDETTE       
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: IN HIS IMAGE FAMILY MEDICINE RESIDENCY
7600 S LEWIS
TULSA OK 74136

Address last updated on 7/19/2010
Phone #: (918) 493-7880
Fax #:
County: TULSA
License: 25807
Dated: 8/1/2008
Expires: 8/1/2011
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ of WI Sch of Med & Public Hlth, Madison, WI
Graduated: 5 / 2007
CME Year: 2011
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:
IN HIS IMAGE FAMILY MEDICINE RESIDENCY
7600 S LEWIS
TULSA OK 74136

Phone #: (918) 493-7880
Fax #:

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