FULLER, MARY ANN - Licensee Information

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FULLER, MARY ANN

Practice Address:	DAVITA GRAPEVINE DIALYSIS 1600 W. NORTHWEST HWY. STE. 100 GRAPEVINE TX 76051 Address last updated on 10/2/2008
Phone #:	(817) 424-4091
Fax #:	(817) 329-2916
County:	NOT OKLAHOMA
License:	427
Dated:	10/1/1985
Expires:	10/31/2008
License Type:	Licensed Dietitian
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:
DAVITA GRAPEVINE DIALYSIS 1600 W. NORTHWEST HWY. STE. 100 GRAPEVINE TX 76051 Phone #: (817) 424-4091 Fax #: (817) 329-2916

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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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