PHAM, CHARLES VAN - Licensee Information

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Last Update: Thursday, May 16, 2024 7:04 PM CDT
Next Update: Friday, May 17, 2024 2:50 AM CDT

PHAM, CHARLES VAN

Practice Address:	INTEGRIS BAPTIST 3300 NW EXPRESSWAY OKLAHOMA CITY OK 73112 Address last updated on 4/29/2024
Phone #:	(405) 949-3011
Fax #:
County:	OKLAHOMA
License:	36
Dated:	5/7/2024
Expires:	1/31/2025
License Type:	Provisionally Licensed Perfusionist
Specialty:

Status:	Active
Status Class:	Provisional 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:
INTEGRIS BAPTIST 3300 NW EXPRESSWAY OKLAHOMA CITY OK 73112 Phone #: (405) 949-3011 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
TREDESSA MICHELLE SCHRADER	LP	140

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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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