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Oklahoma Board of Medical Licensure and Supervision

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

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SANDOVAL LOPEZ, GABRIELA ARELY       
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: ASCENSION ST JOHN BROKEN ARROW -HM
1000 W BOISE CIRCLE
BROKEN ARROW OK 74012

Address last updated on 12/5/2024
Phone #: (918) 994-8000
Fax #:
County: TULSA
License: 4796
Dated: 5/2/2022
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:
ASCENSION ST JOHN BROKEN ARROW -HM
1000 W BOISE CIRCLE
BROKEN ARROW OK 74012

Phone #: (918) 994-8000
Fax #:

Hospital Privileges:

Ascension St. John - Owasso
Owasso, OK
Ascension St. John Hospital - Broken Arrow
Broken Arrow, OK
Ascension St. John Jane Phillips Medical Center
Bartlesville, OK
Ascension St. John Medical Center
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DAPHNEE ANNABELLE NOEL MD 42505
Tate Vance DO 6787

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