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Oklahoma Board of Medical Licensure and Supervision

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CORNELIUS, PENNY SUE       
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: FAMILY MEDICAL CARE OF TULSA
7600 SOUTH LEWIS AVENUE
TULSA OK 74136
Phone #:
Fax #:
County: TULSA
License: 903
Dated: 6/19/1998
Expires: 3/31/2002
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
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:
FAMILY MEDICAL CARE OF TULSA
7600 SOUTH LEWIS AVENUE
TULSA OK 74136

Phone #:
Fax #:

Hospital Privileges:

None listed

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