WAGANER, MELISSA BROOKE - Licensee Information

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WAGANER, MELISSA BROOKE

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:	OK COUNTY SOONERSTART EARLY INTERVENTION UNIT 4545 N LINCOLN BLVD # 250 OKLAHOMA CITY OK 73105 Address last updated on 9/27/2006
Phone #:	(405) 271-9477 x30
Fax #:
County:	OKLAHOMA
License:	1418
Dated:	5/5/2005
Expires:	10/31/2007
Temp. Ltr. Issued:	2/24/2005
Temp. Ltr. Expires:	7/23/2005
License Type:	Occupational Therapist
Specialty:	Pediatrics (OT/OA only)

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	2008

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:
OK COUNTY SOONERSTART EARLY INTERVENTION UNIT 4545 N LINCOLN BLVD # 250 OKLAHOMA CITY OK 73105 Phone #: (405) 271-9477 x30 Fax #:

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