Oklahoma State SealOklahoma State Seal
Oklahoma Board of Medical Licensure and Supervision

Search Results

Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

Return to Search Licensees page

COSTELLO, BRIAN LEE       
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: VANCE AIR FORCE BASE
PRIMARY CARE CLINIC
527 GOTH ROAD
VANCE AFB OK 73705
Phone #:
Fax #:
County: GARFIELD
License: 723
Dated: 5/13/1995
Expires: 3/31/1997
Temp. Ltr. Issued: 5/1/1995
Temp. Ltr. Expires: 7/15/1995
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 1997
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:
VANCE AIR FORCE BASE
PRIMARY CARE CLINIC
527 GOTH ROAD
VANCE AFB OK 73705

Phone #:
Fax #:

Hospital Privileges:

None listed

Return to Search Licensees page