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Oklahoma Board of Medical Licensure and Supervision

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SMITH, KELLY WAYNE       
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: CLINICAL PERFUSION SYSTEMS
1725 EAST 19TH STREET #604
TULSA OK 74104-5424

Address last updated on 2/1/2005
Phone #:
Fax #:
County: TULSA
License: 7
Dated: 6/3/2004
Expires: 1/31/2005
License Type: Provisionally Licensed Perfusionist
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:
CLINICAL PERFUSION SYSTEMS
1725 EAST 19TH STREET #604
TULSA OK 74104-5424

Phone #:
Fax #:

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