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Last Update: Sunday, April 28, 2024 4:03 AM CDT
Next Update: Sunday, April 28, 2024 12:00 PM CDT
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WICKSTROM, KARL THEODORE |
| Practice Address: |
MEDWISE
790 GAIL GARDNER WAY
PRESCOTT AZ 86305
Address last updated on 6/7/2001 |
| Phone #: |
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| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
18752 |
| Dated: |
11/29/1993 |
| Expires: |
11/1/1998 |
| License Type: |
Medical Doctor |
| Specialty: |
Radiology
Other Specialty |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ of WI Sch of Med & Public Hlth, Madison, WI |
| Graduated: |
6 /
1969 |
| CME Year: |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF RADIOLOGY |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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