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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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COLOMBO, MORGANA LUSTOSA       
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: SKINTAP
1942 BROADWAY STREET
STE 314C CO
BOULDER CO 80302

Address last updated on 6/27/2022
Phone #: (703) 416-0770
Fax #:
County: NOT OKLAHOMA
License: 39781
Dated: 5/18/2022
Expires: 5/1/2023
License Type: Medical Doctor
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
CME Year: 2025
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:
SKINTAP
1942 BROADWAY STREET
STE 314C CO
BOULDER CO 80302

Phone #: (703) 416-0770
Fax #:

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