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Oklahoma Board of Medical Licensure and Supervision

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GENSON, JUSTIN DANIEL       
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 3/13/2014
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 1867
Dated: 1/14/2010
Expires: 11/4/2010
Temp. Ltr. Issued: 12/17/2009
Temp. Ltr. Expires: 5/14/2010
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Disciplinary Action
Restricted to: Written Agreement
CME Year: 0
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
11/4/2010 Surrendered License
9/30/2010 Complaint Citation
Board Filings and/or Orders:
11/10/2010
11/04/2010
10/06/2010
09/30/2010
09/30/2010
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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