PUCILLO, JEANNE-MARIE - Licensee Information

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Last Update: Tuesday, May 14, 2024 10:12 AM CDT
Next Update: Tuesday, May 14, 2024 12:00 PM CDT

PUCILLO, JEANNE-MARIE

Practice Address:	WW HASTINGS INDIAN HOSPITAL 100 S BLISS TAHLEQUAH OK 74464
Phone #:	(918) 458-3592
Fax #:
County:	CHEROKEE
License:	996
Dated:	12/20/1999
Expires:	3/31/2004
Temp. Ltr. Issued:	11/16/1999
Temp. Ltr. Expires:	1/31/2000
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:
WW HASTINGS INDIAN HOSPITAL 100 S BLISS TAHLEQUAH OK 74464 Phone #: (918) 458-3592 Fax #:

Hospital Privileges:

None listed

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European Union Residents - GDPR Notice: In accordance with the Oklahoma Open Records Act, all applications submitted are a matter of public record. Social Security Numbers and any HIPAA-protected data are redacted. By applying for and retaining an Oklahoma Medical License, you are giving consent to share your information with anyone requesting it and waiving your right to be notified when your data is requested. We are also required to retain licensee records for a minimum of 10 years after the license expires, so any information submitted will remain a public record for that time period.

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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