BEAVERS, TRACI LEA - Licensee Information

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BEAVERS, TRACI LEA

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:	INTEGRATED SPECIALTY HOSPITAL 8210 NATIONAL AVENUE MIDWEST CITY OK 73110
Phone #:
Fax #:
County:	OKLAHOMA
License:	590
Dated:	5/11/2000
Expires:	10/31/2001
Temp. Ltr. Issued:	3/23/2000
Temp. Ltr. Expires:	7/29/2000
License Type:	Occupational Therapy Assistant
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
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.

Locations:	Hours:	Languages:
INTEGRATED SPECIALTY HOSPITAL 8210 NATIONAL AVENUE MIDWEST CITY OK 73110 Phone #: Fax #:

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