JACKSON, VIVIAN ANNETTE - Licensee Information

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JACKSON, VIVIAN ANNETTE

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:	ATOKA MEMORIAL HOSPITAL 1501 S VIRGINIA ATOKA OK 74525
Phone #:
Fax #:
County:	ATOKA
License:	123
Dated:	9/23/1996
Expires:	11/1/1998
License Type:	Provisional Respiratory Care
Specialty:

Status:	Inactive
Status Class:	Void
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:
ATOKA MEMORIAL HOSPITAL 1501 S VIRGINIA ATOKA OK 74525 Phone #: Fax #:

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