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Next Update: Thursday, December 19, 2024 2:50 AM CST
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GLENN, AMBER L
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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: |
MERCY HOSPITAL ADA
430 N MONTE VISTA STREET
ADA OK 74820
Address last updated on 10/7/2021 |
| Phone #: |
(580) 332-2323 |
| Fax #: |
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| County: |
PONTOTOC |
| License: |
38816 |
| Dated: |
12/1/2021 |
| Expires: |
12/1/2022 |
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Temp.
Lic.
Issued:
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11/1/2021 |
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Temp.
Lic.
Expires:
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1/20/2022 |
| License Type: |
Medical Doctor |
| Specialty: |
Obstetrics & Gynecology |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Wayne State Univ SOM, Detroit Mi 48201 |
| Graduated: |
6 /
2016 |
| CME Year: |
2024 |
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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: |
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| 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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