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Licensing details for: PTL 14215

Name: Wilson, Tyler Martin

License Type: Postgraduate Training License

Primary Status: License Canceled Primary Status Definition

School Name: Drexel University College of Medicine

Graduation Year: 2023

Current Enrolled Postgraduate Training Program

Facility Name: HCA HEALTHCARE/LOS ROBLES REGIONAL MEDICAL CENTER PROGRAM

City: Thousand Oaks

State: California

Speciality: Surgery

Start Date: 07/01/2023

Anticipated End Date: 09/30/2024

Address of Record

215 W Janss Rd
THOUSAND OAKS CA 91360-1847
VENTURA county
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Issuance Date

December 26, 2023

Expiration Date

N/A

Current Date / Time

April 9, 2026
3:12:28 AM

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License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Postgraduate Training License

Related Party Role: Physician & Surgeon

Name: Wilson, Tyler Martin

License/Registration Type: Physician's and Surgeon's

License Number: 206218 Primary Status: License Renewed & Current

Address :
215 W Janss Rd
THOUSAND OAKS CA 91360-1847
VENTURA COUNTY

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