GROSSERODE, TAMMY JEAN - Licensee Information

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GROSSERODE, TAMMY JEAN

Practice Address:	DERMATOLOGY CLINIC 6565 SOUTH YALE SUITE 503 TULSA OK 74136 Address last updated on 12/30/2004
Phone #:	(918) 494-8333
Fax #:
County:	TULSA
License:	1012
Dated:	3/8/2000
Expires:	3/31/2005
Temp. Ltr. Issued:	1/20/2000
Temp. Ltr. Expires:	3/11/2000
License Type:	Physician Assistant
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:

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.

Locations:	Hours:	Languages:
DERMATOLOGY CLINIC 6565 SOUTH YALE SUITE 503 TULSA OK 74136 Phone #: (918) 494-8333 Fax #:

Hospital Privileges:

None listed

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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