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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, April 26, 2024 9:58 AM CDT
Next Update: Friday, April 26, 2024 12:00 PM CDT

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LEATHERMAN, MYLIE BROOKE
Practice Address: 500 N 64TH ST W
MUSKOGEE OK 74401

Address last updated on 8/29/2023
Phone #: (918) 781-2627
Fax #:
County: MUSKOGEE
License: 678
Dated: 2/25/2015
Expires: 8/31/2017
Temp. Ltr. Issued: 11/13/2014
Temp. Ltr. Expires: 3/13/2015
License Type: Apprentice Athletic Trainer
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:
500 N 64TH ST W
MUSKOGEE OK 74401

Phone #: (918) 781-2627
Fax #:

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