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Oklahoma Board of Medical Licensure and Supervision

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

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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.
Practice Address: No Current Practice Address
Address last updated on 3/19/2010
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 1048
Dated: 6/5/2000
Expires: 3/31/2011
Temp. Ltr. Issued: 5/4/2000
Temp. Ltr. Expires: 7/29/2000
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
7/14/2011 Surrendered License
12/10/2010 Complaint Citation
1/18/2009 Probation Ended
1/18/2007 Probation
12/10/2006 Complaint Citation
Board Filings and/or Orders:
07/14/2011
07/13/2011
12/03/2010
12/03/2010
12/10/2006
12/10/2006
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
No Current Practice Address
Phone #:
Fax #:

Hospital Privileges:

None listed

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