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Oklahoma Board of Medical Licensure and Supervision

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ROBERTSON, EDWIN NORRIS JR       
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: 4215 CLASSEN BLVD.
OKLAHOMA CITY OK 73118
Phone #: (636) 536-7932
Fax #:
County: OKLAHOMA
License: 5523
Dated: 12/23/1946
Expires: 9/12/2006
License Type: Medical Doctor
Specialty: Ophthalmology
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Washington Univ in St Louis Sch of Med, St Louis MO
Graduated: / 1937
CME Year: 2006
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 OPHTHALMOLOGY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4215 CLASSEN BLVD.
OKLAHOMA CITY OK 73118

Phone #: (636) 536-7932
Fax #:

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