MUSTAFA, AVALON FORSYTHE - Licensee Information

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Last Update: Wednesday, May 15, 2024 7:09 PM CDT
Next Update: Thursday, May 16, 2024 2:50 AM CDT

MUSTAFA, AVALON FORSYTHE

Practice Address:	COVENANT LIVING OF BIXBY 7300 E 121ST PL S BIXBY OK 74008 Address last updated on 9/2/2023
Phone #:	(847) 510-3307
Fax #:
County:	TULSA
License:	2829
Dated:	6/6/2023
Expires:	10/31/2024
License Type:	Licensed Dietitian
Specialty:

Status:	Active
Status Class:	Fully Licensed
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:
COVENANT LIVING OF BIXBY 7300 E 121ST PL S BIXBY OK 74008 Phone #: (847) 510-3307 Fax #:

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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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