FERNANDEZ, DAVID RAY - Licensee Information

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FERNANDEZ, DAVID RAY

Practice Address:	No Current Practice Address Address last updated on 11/24/2003
Phone #:
Fax #:
County:	OKLAHOMA
License:	787
Dated:	11/14/1996
Expires:	3/31/2004
Temp. Ltr. Issued:	11/7/1996
Temp. Ltr. Expires:	11/16/1996
License Type:	Physician Assistant
Specialty:

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

Pending and/or Past Disciplinary Actions:

Date

Action

Reasons

Remarks

11/20/2003

Probation

Board Filings and/or Orders:
12/04/2003
05/01/2003
05/01/2003

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
No Current Practice Address Phone #: 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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