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BROADWATER, JOHN RALPH       
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: UNIV OF ARKANSAS
P O BOX 5210
LITTLE ROCK AR 72215

Address last updated on 12/23/1999
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 8733
Dated: 10/18/1967
Expires: 6/30/1989
License Type: Medical Doctor
Specialty: RADIOLOGY, THERAPEUTIC
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Washington Univ in St Louis Sch of Med, St Louis MO
Graduated: / 1958
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 RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
UNIV OF ARKANSAS
P O BOX 5210
LITTLE ROCK AR 72215

Phone #:
Fax #:

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