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CLARK, DOUGLAS LLOYD       
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: 1301 15TH AVE WEST
ONCOLOGY DEPARTMENT
WILLISTON ND

Address last updated on 1/14/2013
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 26077
Dated: 2/4/2008
Expires: 2/1/2014
Temp. Lic. Issued: 1/31/2008
Temp. Lic. Expires: 3/15/2008
License Type: Medical Doctor
Specialty: Radiation Oncology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduated: 5 / 1988
CME Year: 2014
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: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1301 15TH AVE WEST
ONCOLOGY DEPARTMENT
WILLISTON ND

Phone #:
Fax #:
Mon:
Tue:
Wed:
Thu:
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