MAYNE, LAUREN KELLEY - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

MAYNE, LAUREN KELLEY

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:	OU STEPHENSON CANCER CENTER 800 NE 10TH STREET OKLAHOMA CITY OK 73104 Address last updated on 5/5/2024
Phone #:	(405) 271-8001
Fax #:
County:	OKLAHOMA
License:	4410
Dated:	10/20/2020
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:
OU STEPHENSON CANCER CENTER 800 NE 10TH STREET OKLAHOMA CITY OK 73104 Phone #: (405) 271-8001 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
JERED MICHAEL COOK	MD	34453
SEAN MICHAEL HALLERAN	MD	29644
MANU RAJ PANDEY	MD	38789
ALAN RICHARD PULS	MD	13123

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