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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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NG, GRACE       
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: UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICIN
4502 E. 41ST STREET
TULSA OK 74135

Address last updated on 5/4/2017
Phone #: (918) 619-4400
Fax #:
County: TULSA
License: 29882
Dated: 7/1/2014
Expires: 7/1/2018
License Type: Medical Doctor
Specialty: General Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Paul L Foster Sch of Med, TX Tech Univ, El Paso, TX
Graduated: 5 / 2013
CME Year: 2020
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:
UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICIN
4502 E. 41ST STREET
TULSA OK 74135

Phone #: (918) 619-4400
Fax #:

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