DIEBOLD, CHAD LEWIS - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

DIEBOLD, CHAD LEWIS

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:	ST. FRANCIS HOSPITAL VINITA 735 NORTH FOREMAN STREET VINITA OK 74301 Address last updated on 10/18/2024
Phone #:	(918) 256-9207
Fax #:
County:	CRAIG
License:	1642
Dated:	3/5/2010
Expires:	10/31/2025
Temp. Ltr. Issued:	12/28/2009
Temp. Ltr. Expires:	3/12/2010
License Type:	Occupational Therapist
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:
ST. FRANCIS HOSPITAL VINITA 735 NORTH FOREMAN STREET VINITA OK 74301 Phone #: (918) 256-9207 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
JENNIFER DAWN NEUGIN	OA	1597

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