WAGNER, MELISSA DAWN - Licensee Information

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WAGNER, MELISSA DAWN

Practice Address:	U.S. FOODSERVICE 10211 NORTH I-35 SERVICE RD OKLAHOMA CITY OK 73131 Address last updated on 10/2/2012
Phone #:	(405) 475-4660 x2158
Fax #:
County:	OKLAHOMA
License:	1397
Dated:	11/3/2005
Expires:	10/31/2013
Temp. Ltr. Issued:	7/28/2005
Temp. Ltr. Expires:	11/5/2005
License Type:	Licensed Dietitian
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:
U.S. FOODSERVICE 10211 NORTH I-35 SERVICE RD OKLAHOMA CITY OK 73131 Phone #: (405) 475-4660 x2158 Fax #:

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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