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DOMINGUEZ, HANNAH JEAN MENDEZ
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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.
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| Practice Address: |
CROWLEY RIDGE CARE CTR
16643 N OUTER RD
DEXTER MO 63841
Address last updated on 11/17/2007 |
| Phone #: |
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| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
1505 |
| Dated: |
2/14/2007 |
| Expires: |
10/31/2008 |
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Temp.
Ltr.
Issued:
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11/16/2006 |
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Temp.
Ltr.
Expires:
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3/24/2007 |
| License Type: |
Occupational Therapist |
| Specialty: |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| CME Year: |
2008 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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