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Next Update: Thursday, December 19, 2024 12:00 PM CST
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WILSON, JACQUELYN GRAVES
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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.
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| Practice Address: |
3601 S RENA DAWN LANE
EDMOND OK 73013
Address last updated on 12/23/1999 |
| Phone #: |
(405) 340-8650 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
8397 |
| Dated: |
2/28/1966 |
| Expires: |
2/1/2007 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatrics |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Howard Univ Coll Of Med, Washington DC 20059 |
| Graduated: |
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1962 |
| CME Year: |
2007 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PEDIATRICS |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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