PIERCE-DUTCH, STACIE LYNN - 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

PIERCE-DUTCH, STACIE LYNN

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:	RALPH H JOHNSON VAMC 109 BEE ST CHARLESTON SC 29401 Address last updated on 10/14/2024
Phone #:	(843) 577-5011
Fax #:
County:	NOT OKLAHOMA
License:	2809
Dated:	8/2/2017
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:
RALPH H JOHNSON VAMC 109 BEE ST CHARLESTON SC 29401 Phone #: (843) 577-5011 Fax #:

Hospital Privileges:

Hospital(s) Not In Oklahoma
,

Name:	Type:	License Number:
Primary Supervisor(s):
ANDREW LEE FOOTE	MD	24534
ELIZABETH ANN FOOTE	MD	24533
ROBERT CHRISTIAN WARD	MD	31608

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