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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Sunday, May 5, 2024 4:30 PM CDT

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GILLIAM, MARY ANN
Practice Address: 14719 CO RD 3585
ADA OK 74820-3063

Address last updated on 5/22/2003
Phone #: (580) 436-6422
Fax #: (580) 436-1795
County: PONTOTOC
License: 9089
Dated: 6/11/1969
Expires: 6/1/2007
License Type: Medical Doctor
Specialty: Legal Medicine
Pediatrics
Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 1968
CME Year: 2007
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
5/11/2000 Probation
10/1/1993 Probation Ended
10/26/1990 Probation
10/10/1987 Probation Ended
9/16/1985 Suspension, License
9/22/1984 Probation
Board Filings and/or Orders:
05/11/2000
05/10/1996
03/23/1996
01/19/1996
09/16/1995
10/01/1993
11/01/1991
10/26/1990
05/18/1984
05/18/1984
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:
14719 CO RD 3585
ADA OK 74820-3063

Phone #: (580) 436-6422
Fax #: (580) 436-1795

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