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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, April 29, 2024 1:43 PM CDT
Next Update: Monday, April 29, 2024 4:30 PM CDT

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TITTLE, BEN JACKSON
Practice Address: ETHEREAL MEDICAL AESTHETICS PC
8301 E 51ST ST, SUITE 235
TULSA OK 74145

Address last updated on 6/8/2023
Phone #: (918) 890-1244
Fax #:
County: TULSA
License: 41833
Dated: 6/2/2023
Expires: 6/1/2024
License Type: Medical Doctor
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
CME Year: 2026
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.
Certifications:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
ETHEREAL MEDICAL AESTHETICS PC
8301 E 51ST ST, SUITE 235
TULSA OK 74145

Phone #: (918) 890-1244
Fax #:

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