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Oklahoma Board of Medical Licensure and Supervision

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GREEN, AMBRE JAMARRA       
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: IDEAL IMAGE
1841 BELLE ISLE BLVD
STE L
OKLAHOMA CITY OK 73118

Address last updated on 4/5/2017
Phone #: (405) 445-7504
Fax #:
County: OKLAHOMA
License: 2663
Dated: 5/3/2016
Expires: 3/31/2018
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2018
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:
IDEAL IMAGE
1841 BELLE ISLE BLVD
STE L
OKLAHOMA CITY OK 73118

Phone #: (405) 445-7504
Fax #:

Hospital Privileges:

None listed

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