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Oklahoma Board of Medical Licensure and Supervision

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

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MITCHELL, DANE C       
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: STANBRO HEALTHCARE GROUP
OUTPATIENT MENTAL HEALTH
2000 E 15TH ST STE 400A
EDMOND OK 73013

Address last updated on 2/15/2024
Phone #: (405) 341-1697
Fax #:
County: OKLAHOMA
License: 5015
Dated: 4/25/2023
Expires: 3/31/2025
Temp. Ltr. Issued: 4/4/2023
Temp. Ltr. Expires: 5/11/2023
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:
STANBRO HEALTHCARE GROUP
OUTPATIENT MENTAL HEALTH
2000 E 15TH ST STE 400A
EDMOND OK 73013

Phone #: (405) 341-1697
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
PETER BRENT STANBRO MD 27353

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