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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, November 17, 2024 3:48 AM CST
Next Update: Sunday, November 17, 2024 12:00 PM CST

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PHAM, CHARLES VAN       
Practice Address: INTEGRIS BAPTIST
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Address last updated on 4/29/2024
Phone #: (405) 949-3011
Fax #:
County: OKLAHOMA
License: 36
Dated: 5/7/2024
Expires: 1/31/2025
License Type: Provisionally Licensed Perfusionist
Specialty:
Status: Active
Status Class: Provisional 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:
INTEGRIS BAPTIST
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Phone #: (405) 949-3011
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
TREDESSA MICHELLE SCHRADER LP 140

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