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ROCHE, ROBERT RAPHAEL
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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.
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| Practice Address: |
3520 PIEDMON ROAD NE
SUITE 250
ATLANTA GA 30305
Address last updated on 11/30/2011 |
| Phone #: |
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| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
26679 |
| Dated: |
12/18/2008 |
| Expires: |
12/1/2012 |
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Temp.
Lic.
Issued:
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12/5/2008 |
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Temp.
Lic.
Expires:
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1/30/2009 |
| License Type: |
Medical Doctor |
| Specialty: |
Diagnostic Radiology |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Loyola Univ Of Chicago Stritch Sch Of Med, Maywood Il 60153 |
| Graduated: |
6 /
1976 |
| CME Year: |
2014 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF RADIOLOGY |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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