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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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BUSCH, APRIL       
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: 4205 OK-66
EL RENO OK 73036

Address last updated on 2/1/2024
Phone #:
Fax #:
County: CANADIAN
License: 2685
Dated: 12/13/2016
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:
4205 OK-66
EL RENO OK 73036

Phone #:
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DUSTIN RILEY BAKER MD 23973
JOSEPH CLIFTON BROOME MD 23006
CYRUS DEAN MOTAZEDI DO 3977
SHERRIE WILLIAMSON DO 2988

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