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HEREFORD, JUSTIN LYLE       
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: RESPIRATORY THERAPY
10220 EVANS RD
MARIETTA OK 73448

Address last updated on 2/20/2019
Phone #: (580) 624-0412
Fax #:
County: LOVE
License: 3749
Dated: 5/9/2012
Expires: 1/30/2021
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:
RESPIRATORY THERAPY
10220 EVANS RD
MARIETTA OK 73448

Phone #: (580) 624-0412
Fax #:

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