BERGDALL, JAMI LYNETTE - Licensee Information

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

BERGDALL, JAMI LYNETTE

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:	FAIRVIEW FELLOWSHIP HOME - ODYSSEY HEALTH CARE 605 E STATE ROAD FAIRVIEW OK 73737 Address last updated on 10/21/2024
Phone #:	(580) 227-3783
Fax #:
County:	MAJOR
License:	1152
Dated:	11/1/2010
Expires:	10/31/2025
Temp. Ltr. Issued:	10/8/2010
Temp. Ltr. Expires:	11/4/2010
License Type:	Occupational Therapy Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

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.

Locations:	Hours:	Languages:
FAIRVIEW FELLOWSHIP HOME - ODYSSEY HEALTH CARE 605 E STATE ROAD FAIRVIEW OK 73737 Phone #: (580) 227-3783 Fax #:

Name:	Type:	License Number:
Primary Supervisor(s):
SHANNON L. BALENTI	OT	501
DENNA KAY JANTZEN	OT	1085

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