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Next Update: Thursday, December 19, 2024 2:50 AM CST
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JU, NA RAE
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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: |
10717 N MAY AVENUE
SUITE B
OKLAHOMA OK 73120
Address last updated on 11/30/2022 |
| Phone #: |
(405) 849-5959 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
39769 |
| Dated: |
7/21/2022 |
| Expires: |
7/1/2023 |
| License Type: |
Medical Doctor |
| Specialty: |
Emergency Medicine |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Washington Univ in St Louis Sch of Med, St Louis MO |
| Graduated: |
5 /
2011 |
| CME Year: |
2025 |
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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: |
AMERICAN BOARD OF EMERGENCY MEDICINE |
| 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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