BOLTON, SHARON P - 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

BOLTON, SHARON P

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:	OKLAHOMA FAMILY WELLNESS CLINIC 1705 S RENAISSANCE BLVD EDMOND OK 73013 Address last updated on 3/14/2024
Phone #:	(405) 844-8572
Fax #:
County:	OKLAHOMA
License:	1355
Dated:	5/10/2004
Expires:	3/31/2025
Temp. Ltr. Issued:	3/11/2004
Temp. Ltr. Expires:	5/31/2004
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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:
OKLAHOMA FAMILY WELLNESS CLINIC 1705 S RENAISSANCE BLVD EDMOND OK 73013 Phone #: (405) 844-8572 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
GRACIELA CRISTINA GALLARDO	MD	25140
ANA AHLUWALIA KUMAR	MD	22467
KESHAV PANDAY	MD	30042
DAVID BURTON SPEEGLE	MD	25090
LINDA ANN ZACHARIAS	MD	24152

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