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Oklahoma Board of Medical Licensure and Supervision

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TRACEWELL, GEORGE LOGAN       
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: 1821 E 9TH ST
OKMULGEE OK 74447-5403
Phone #:
Fax #:
County: OKMULGEE
License: 4677
Dated: 12/16/1938
Expires: 6/30/1989
License Type: Medical Doctor
Specialty: Otolaryngology
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduated: / 1935
CME Year:
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 OTOLARYNGOLOGY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1821 E 9TH ST
OKMULGEE OK 74447-5403

Phone #:
Fax #:

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