GANNAWAY, MALLERY GRAY - Licensee Information

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Last Update: Sunday, May 5, 2024 1:39 PM CDT
Next Update: Sunday, May 5, 2024 4:30 PM CDT

GANNAWAY, MALLERY GRAY

Practice Address:	SMM HEALTH BONE & JOINT HOSPITAL 1111 N DEWEY AVE OKLAHOMA CITY OK 73103 Address last updated on 7/17/2023
Phone #:
Fax #:
County:	OKLAHOMA
License:	1125
Dated:	9/1/2019
Expires:	8/31/2024
Temp. Ltr. Issued:	5/30/2019
Temp. Ltr. Expires:	9/12/2019
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
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:
SMM HEALTH BONE & JOINT HOSPITAL 1111 N DEWEY AVE OKLAHOMA CITY OK 73103 Phone #: Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
JOHN LARSON GLOMSET III	MD	29497

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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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