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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, April 22, 2018 5:13 PM CDT
Next Update: Monday, April 23, 2018 2:50 AM CDT

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Practice Address: 4802 S 109TH E AVE
TULSA OK 74146

Address last updated on 1/21/2018
Phone #:
Fax #:
License: 307
Dated: 3/14/2002
Expires: 8/31/2003
Temp. Ltr. Issued: 12/13/2001
Temp. Ltr. Expires: 3/16/2002
License Type: Apprentice Athletic Trainer
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
Disciplinary History: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
4802 S 109TH E AVE
TULSA OK 74146

Phone #:
Fax #:

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