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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Saturday, May 4, 2024 2:50 AM CDT

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THEODORE, ALEXANDER
Practice Address: Not Currently Practicing
SALT LAKE CITY UT 84117

Address last updated on 4/26/2013
Phone #: (801) 261-2060
Fax #:
County: NOT OKLAHOMA
License: 11907
Dated: 8/11/1978
Expires: 8/30/2007
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Disciplinary Action
Restricted to:
Registered to Dispense: NO
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduated: 12 / 1974
CME Year: 2009
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
11/1/2007 Surrendered License
8/30/2007 Suspension, License
7/21/2005 Probation
Board Filings and/or Orders:
11/01/2007
10/24/2007
08/30/2007
08/30/2007
08/30/2007
07/21/2005
03/31/2005
03/31/2005
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
Not Currently Practicing
SALT LAKE CITY UT 84117

Phone #: (801) 261-2060
Fax #:
Spanish

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