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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, April 28, 2024 6:57 PM CDT
Next Update: Monday, April 29, 2024 2:50 AM CDT

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PEACOCK, HANNAH MARIE
Practice Address: 2212 NORTH BROADWAY
MOORE OK 73160

Address last updated on 3/27/2024
Phone #: (405) 285-7222
Fax #:
County: OKLAHOMA
License: 3211
Dated: 5/29/2020
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
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:
2212 NORTH BROADWAY
MOORE OK 73160

Phone #: (405) 285-7222
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
AHMAD ASHFAQ MD 30335
James Le DO 6694

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