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Oklahoma Board of Medical Licensure and Supervision

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JACOB, SHAJI       
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: INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Address last updated on 11/4/2010
Phone #: (405) 949-3530
Fax #:
County: OKLAHOMA
License: 3483
Dated: 11/4/2010
Expires: 11/30/2012
Temp. Ltr. Issued: 9/28/2010
Temp. Ltr. Expires: 11/4/2010
License Type: Respiratory Care Practitioner
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:
INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Phone #: (405) 949-3530
Fax #:

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