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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, April 24, 2024 3:08 PM CDT
Next Update: Thursday, April 25, 2024 2:50 AM CDT

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DETWEILER, EDWIN LYLE
Practice Address: SW OKLAHOMA STATE UNIVERSITY
100 CAMPUS DRIVE
WEATHERFORD OK 73096

Address last updated on 1/5/2024
Phone #: (580) 774-3073
Fax #:
County: BLAINE
License: 624
Dated: 9/16/2010
Expires: 8/31/2024
Temp. Ltr. Issued: 8/25/2010
Temp. Ltr. Expires: 9/17/2010
License Type: Athletic Trainer
Specialty:
Status: Active
Status Class: Fully Licensed
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:
SW OKLAHOMA STATE UNIVERSITY
100 CAMPUS DRIVE
WEATHERFORD OK 73096

Phone #: (580) 774-3073
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
BLAKE ALLEN BADGETT MD 22800
MICHAEL EDWIN KIEHN MD 23364

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