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HENNINGER, CAMILLE ANN       
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: 6195 LUSK BOULEVARD
SUITE 250
SAN DIEGO CA 92121

Address last updated on 8/3/2022
Phone #: (858) 859-1188
Fax #:
County: NOT OKLAHOMA
License: 35137
Dated: 9/6/2019
Expires: 9/1/2022
License Type: Medical Doctor
Specialty: Dermatology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: USUHS F E Hebert Sch of Med Bethesda Md 20814
Graduated: 5 / 2002
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 DERMATOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
6195 LUSK BOULEVARD
SUITE 250
SAN DIEGO CA 92121

Phone #: (858) 859-1188
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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