HENDERSON, JESSICA KIM - Licensee Information

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HENDERSON, JESSICA KIM

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:	NORMAN REGIONAL HOSPITAL 901 NORTH PORTER AVENUE NORMAN OK 73071 Address last updated on 9/5/2014
Phone #:	(405) 307-2171
Fax #:
County:	CLEVELAND
License:	627
Dated:	7/14/2011
Expires:	10/31/2011
Temp. Ltr. Issued:	7/8/2011
Temp. Ltr. Expires:	7/15/2011
License Type:	Provisional Dietitian
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	0

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:
NORMAN REGIONAL HOSPITAL 901 NORTH PORTER AVENUE NORMAN OK 73071 Phone #: (405) 307-2171 Fax #:

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