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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, April 23, 2018 2:42 PM CDT
Next Update: Monday, April 23, 2018 4:30 PM CDT

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ELLIS, JERI LYNN
Practice Address: 420 N. KICKAPOO
SHAWNEE OK 74804

Address last updated on 2/2/2018
Phone #: (405) 273-9327
Fax #: (405) 273-9300
County: POTTAWATOMIE
License: 20048
Dated: 2/24/1997
Expires: 2/1/2018
License Type: Medical Doctor
Specialty: General Practice
Occupational Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: D Geffen Sch of Med-UCLA, Los Angeles CA 90095
Graduated: 6 / 1989
CME Year: 2019
Disciplinary History:
Date Action Reasons Remarks
1/31/2018 Voluntary Submittal to Jurisdiction Prescribing w/o Legitimate Medical Need
Allowing Unlicensed Person to Practice
Failure To Maintain Records
No prescribing of CDS, contract with OHPP, practice must be approved by the Board Secretary.
1/8/2018 Complaint Citation Allegations as Listed in the Complaint
CDS Violation
Failure To Maintain Records
Board Orders:
01/31/2018
01/08/2018
01/08/2018
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
420 N. KICKAPOO
SHAWNEE OK 74804

Phone #: (405) 273-9327
Fax #: (405) 273-9300
Mon: 9:00AM - 7:00PM
Tue: 9:00AM - 7:00PM
Wed:
Thu: 9:00AM - 7:00PM
Fri:
Sat: 10:00AM - 5:00PM PRN
Sun: CLOSED
420 N Kickapoo
SHAWNEE, OK 74804

Phone #: (405) 273-9300
Fax #:
Mon: 8:00AM - 4:00PM
Tue: 8:00AM - 4:00PM
Wed: 8:00AM - 4:00PM
Thu: 8:00AM - 4:00PM
Fri: 8:00AM - 12:00PM
Sat: closed
Sun: closed

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