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Oklahoma Board of Medical Licensure and Supervision

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MERTENS, ADYSEN LEIGH       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: INTEGRIS GROVE HOSPITAL
1001 E 18TH ST
GROVE OK 74344

Address last updated on 10/1/2019
Phone #: (918) 787-3427
Fax #:
County: DELAWARE
License: 4015
Dated: 11/7/2013
Expires: 11/30/2019
Temp. Ltr. Issued: 9/6/2013
Temp. Ltr. Expires: 11/7/2013
License Type: Respiratory Care Practitioner
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:
INTEGRIS GROVE HOSPITAL
1001 E 18TH ST
GROVE OK 74344

Phone #: (918) 787-3427
Fax #:

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