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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Wednesday, May 1, 2024 12:00 PM CDT

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HANSEN, MATTHEW VERNON
Practice Address: 12TH MEDICAL GROUP
RANDOLPH AFB TX 78150

Address last updated on 3/28/2003
Phone #: (210) 565-3821
Fax #:
County: NOT OKLAHOMA
License: 775
Dated: 6/17/1996
Expires: 3/31/2004
Temp. Ltr. Issued: 5/31/1996
Temp. Ltr. Expires: 7/27/1996
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:
12TH MEDICAL GROUP
RANDOLPH AFB TX 78150

Phone #: (210) 565-3821
Fax #:

Hospital Privileges:

None listed

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