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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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KUKUK, DAWN TERESA       
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: NOBLE COUNTY HEALTH DEPARTMENT
300 E. FIR STREET
PERRY OK 73077-4902

Address last updated on 10/28/2024
Phone #: (580) 336-2257
Fax #: (580) 336-2480
County: NOBLE
License: 326
Dated: 11/1/1999
Expires: 10/31/2000
Temp. Ltr. Issued: 9/2/1999
Temp. Ltr. Expires: 11/6/1999
License Type: Provisional Dietitian
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:
NOBLE COUNTY HEALTH DEPARTMENT
300 E. FIR STREET
PERRY OK 73077-4902

Phone #: (580) 336-2257
Fax #: (580) 336-2480

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