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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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BRADSHAW, JERRI LYNN       
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: 16370 HWY 70
LONE GROVE OK 73443

Address last updated on 8/19/2024
Phone #: (580) 224-2862
Fax #: (580) 224-2863
County: OKLAHOMA
License: 1402
Dated: 4/1/2005
Expires: 3/31/2025
Temp. Ltr. Issued: 1/13/2005
Temp. Ltr. Expires: 4/2/2005
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:
16370 HWY 70
LONE GROVE OK 73443

Phone #: (580) 224-2862
Fax #: (580) 224-2863

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DEREK TODD LANDIS MD 25666
JEFFREY ALAN ROTHER MD 17679

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