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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Wednesday, December 25, 2024 12:00 PM CST

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PARK, SUSAN       
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: VIRTUAL RADIOLOGIC
11995 SINGLETREE LANE STE. 500
EDEN PRAIRIE MN 55344

Address last updated on 2/8/2021
Phone #: (952) 595-1100
Fax #:
County: NOT OKLAHOMA
License: 29662
Dated: 3/4/2013
Expires: 3/1/2022
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: NEW YORK MED COLL, VALHALLA NY 10595
Graduated: 5 / 2001
CME Year: 2022
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 (Diagnostic Radiology specific)
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Hospital Not Listed
,
Hospital(s) Not In Oklahoma
,
Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
Locations: Hours: Languages:
VIRTUAL RADIOLOGIC
11995 SINGLETREE LANE STE. 500
EDEN PRAIRIE MN 55344

Phone #: (952) 595-1100
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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