MAX, HOLLY MARK - Licensee Information

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Last Update: Friday, November 22, 2024 1:58 PM CST
Next Update: Friday, November 22, 2024 4:30 PM CST

MAX, HOLLY MARK

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:	HEART SOLUTIONS OF OKLAHOMA 10413 GREEN BRIAR PKWY OKLAHOMA CITY OK 73159 Address last updated on 10/8/2024
Phone #:	(405) 691-4665
Fax #:
County:	OKLAHOMA
License:	4569
Dated:	4/21/2021
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:
HEART SOLUTIONS OF OKLAHOMA 10413 GREEN BRIAR PKWY OKLAHOMA CITY OK 73159 Phone #: (405) 691-4665 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
RIAZ AHMED SIRAJUDDIN	MD	22726

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