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Oklahoma Board of Medical Licensure and Supervision

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FOLSOM, CHARLES TANDY       
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: 3782 KORNEGAY ROAD
SAN BENITO TX 78586-0004

Address last updated on 5/8/2009
Phone #: (956) 399-7311
Fax #: (956) 399-7311
County: NOT OKLAHOMA
License: 8415
Dated: 6/16/1965
Expires: 6/1/2009
License Type: Medical Doctor
Specialty: General Practice
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1965
CME Year: 2010
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 PATHOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
3782 KORNEGAY ROAD
SAN BENITO TX 78586-0004

Phone #: (956) 399-7311
Fax #: (956) 399-7311

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