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MAXWELL, OLEN DALE       
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: 1001 THORNTON ROAD
SUITE 309
LITHIA SPRINGS GA 30057-2613

Address last updated on 12/23/1999
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 9443
Dated: 6/11/1971
Expires: 6/1/1998
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: VANDERBILT UNIV SCH OF MED, NASHVILLE TN 37232
Graduated: / 1966
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 PSYCHIATRY AND NEUROLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1001 THORNTON ROAD
SUITE 309
LITHIA SPRINGS GA 30057-2613

Phone #:
Fax #:

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