FORREST, CLINTON RICHARD - Licensee Information

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FORREST, CLINTON RICHARD

Practice Address:	PO BOX 260 LEXINGTON OK 73051 Address last updated on 3/9/2011
Phone #:	(405) 527-5676
Fax #:
County:	CLEVELAND
License:	975
Dated:	7/15/1999
Expires:	3/31/2012
Temp. Ltr. Issued:	10/29/1998
Temp. Ltr. Expires:	10/29/1999
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:
PO BOX 260 LEXINGTON OK 73051 Phone #: (405) 527-5676 Fax #:

Hospital Privileges:

None listed

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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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