PENNER, MADELINE ANNE - Licensee Information

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

PENNER, MADELINE ANNE

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:	ARUBAH COMMUNITY CLINIC (VOLUNTEER) 1021 W. MAIN COLLINSVILLE OK 74021-3131 Address last updated on 5/13/2024
Phone #:	(918) 371-3806
Fax #:
County:	ROGERS
License:	2437
Dated:	1/15/2015
Expires:	3/31/2025
Temp. Ltr. Issued:	1/5/2015
Temp. Ltr. Expires:	1/16/2015
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:
ARUBAH COMMUNITY CLINIC (VOLUNTEER) 1021 W. MAIN COLLINSVILLE OK 74021-3131 Phone #: (918) 371-3806 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
JOHN GLADSTONE ABRAHAM	MD	27255
ABEL LEE LAU	MD	17057
ROSE ELLEN O' SLOAT	MD	26414
LEAH UPTON	DO	5453
LAUREL KATRINA WILLISTON	MD	22584

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