Oklahoma State SealOklahoma State Seal
Oklahoma Board of Medical Licensure and Supervision

Search Results

Last Update: Tuesday, December 24, 2024 6:44 PM CST
Next Update: Wednesday, December 25, 2024 2:50 AM CST

Return to Search Licensees page

MOONEYHAM, MANDY SUZANNE       
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: WASHINGTON REGIONAL
3215 N. NORTH HILLS BLVD
FAYETTEVILLE AR 72703

Address last updated on 11/22/2021
Phone #: (479) 463-1065
Fax #:
County: NOT OKLAHOMA
License: 2266
Dated: 5/3/2013
Expires: 3/31/2015
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 0
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:
WASHINGTON REGIONAL
3215 N. NORTH HILLS BLVD
FAYETTEVILLE AR 72703

Phone #: (479) 463-1065
Fax #:

Hospital Privileges:

None listed

Return to Search Licensees page