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WAGENMAN, BENJAMIN LEE       
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: OUHSC DEPT OF PATHOLOGY
940 STANTON L. YOUNG BLVD BMSB 451
OKLAHOMA CITY OK 73104

Address last updated on 6/18/2010
Phone #: (405) 271-2422
Fax #: (405) 271-4020
County: OKLAHOMA
License: 27070
Dated: 7/1/2009
Expires: 7/1/2011
Temp. Lic. Issued: 6/5/2009
Temp. Lic. Expires: 7/24/2009
License Type: Medical Doctor
Specialty: Clinical Pathology
Blood Banking/Transfusion Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduated: 5 / 2005
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
OUHSC DEPT OF PATHOLOGY
940 STANTON L. YOUNG BLVD BMSB 451
OKLAHOMA CITY OK 73104

Phone #: (405) 271-2422
Fax #: (405) 271-4020
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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