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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Thursday, December 19, 2024 2:50 AM CST

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DAVIDSON, WALLACE NORMAN 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: 630 RUNNYMEDE ROAD
DAYTON OH 45419
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 6274
Dated: 6/7/1951
Expires: 6/1/1997
License Type: Medical Doctor
Specialty: Dermatology
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1951
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 DERMATOLOGY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
630 RUNNYMEDE ROAD
DAYTON OH 45419

Phone #:
Fax #:

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