MUNDORFF, MARISA RACHELLE - Licensee Information

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Next Update: Monday, April 29, 2024 12:00 PM CDT

MUNDORFF, MARISA RACHELLE

Practice Address:	OU MEDICAL CENTER 1200 EVERETT DR RM BNP 603 OKLAHOMA CITY OK 73104 Address last updated on 10/16/2008
Phone #:	(405) 271-5390
Fax #:
County:	OKLAHOMA
License:	549
Dated:	2/29/2008
Expires:	10/31/2008
Temp. Ltr. Issued:	1/25/2008
Temp. Ltr. Expires:	3/15/2008
License Type:	Provisional Dietitian
Specialty:

Status:	Inactive
Status Class:	Expired License
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:
OU MEDICAL CENTER 1200 EVERETT DR RM BNP 603 OKLAHOMA CITY OK 73104 Phone #: (405) 271-5390 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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