PACKER, JOHNNA NADINE - Licensee Information

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PACKER, JOHNNA NADINE

Practice Address:	GRAND LAKE MENTAL HEALTH CENTER 17599 S. HIGHWAY 88 CLAREMORE OK 74017 Address last updated on 3/27/2012
Phone #:	(918) 273-1841
Fax #:
County:	ROGERS
License:	1854
Dated:	10/19/2009
Expires:	3/31/2013
Temp. Ltr. Issued:	10/2/2009
Temp. Ltr. Expires:	3/30/2010
License Type:	Physician Assistant
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	0

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:
GRAND LAKE MENTAL HEALTH CENTER 17599 S. HIGHWAY 88 CLAREMORE OK 74017 Phone #: (918) 273-1841 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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