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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, December 14, 2018 5:22 PM CST
Next Update: Saturday, December 15, 2018 2:50 AM CST

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BOUCHER, JEREMY MICHAEL
Practice Address: DYNAMIC MEDICAL WELLNESS
11212 N. MAY AVE
STE 204
OKLAHOMA CITY OK 73120

Address last updated on 8/1/2018
Phone #: (405) 276-8074
Fax #: (405) 286-8056
County: OKLAHOMA
License: 23387
Dated: 8/18/2004
Expires: 8/1/2019
License Type: Medical Doctor
Specialty: General Preventive Medicine
Pain Medicine
Addiction Medicine
Emergency Medicine
Anesthesiology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2003
CME Year: 2019
Disciplinary History:
Date Action Reasons Remarks
8/19/2016 Probation Ended
1/16/2014 Modification Order Motion to modify terms of probation and for approval of participation in fellowship program.
7/25/2013 Modification Order Probation modified to allow extended work hours.
8/19/2011 Probation Alcohol Abuse
Fraud Obtaining License Credentials
Sexual Misconduct
CDS Violation
5years
5/19/2011 Suspension, License Alcohol Abuse
Fraud Obtaining License Credentials
Sexual Misconduct
CDS Violation
Suspended 3 months- $20,000.00 Administrative Fine, Community Service followed by 5 yrs probation.
3/23/2011 Complaint Citation9483 Alcohol Abuse
Board Orders:
01/24/2014
08/02/2013
05/19/2011
03/18/2011
03/18/2011
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF ANESTHESIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
DYNAMIC MEDICAL WELLNESS
11212 N. MAY AVE
STE 204
OKLAHOMA CITY OK 73120

Phone #: (405) 276-8074
Fax #: (405) 286-8056
Mon: 8:00AM - 5:30PM
Tue:
Wed: 8:00AM - 5:30PM
Thu:
Fri: 8:00AM - 5:30PM
Sat:
Sun:

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