STOLL, DAVID L. - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

STOLL, DAVID L.

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:	UTICA PARK CLINIC 10512 N 110TH EAST AVE STE 220 OWASSO OK 74055 Address last updated on 12/5/2024
Phone #:	(918) 376-8959
Fax #:	(918) 376-8999
County:	TULSA
License:	2678
Dated:	7/14/2016
Expires:	3/31/2025
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:
UTICA PARK CLINIC 10512 N 110TH EAST AVE STE 220 OWASSO OK 74055 Phone #: (918) 376-8959 Fax #: (918) 376-8999

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
CHAD CRAWLEY	DO	4449
JON ORJALA	DO	3332

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