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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Thursday, December 19, 2024 12:00 PM CST

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MOSELEY, JACK ELLIS       
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: 1118 S CLIFTON
WICHITA KS 67218
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 6540
Dated: 6/11/1953
Expires: 6/30/1990
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1953
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:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1118 S CLIFTON
WICHITA KS 67218

Phone #:
Fax #:

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