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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, April 19, 2018 1:03 PM CDT
Next Update: Thursday, April 19, 2018 4:30 PM CDT

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BASS, JY MAX
Practice Address: CADDO-KIOWA TECH CENTER
PO BOX 190
FORT COBB OK 73038

Address last updated on 2/13/2018
Phone #: (405) 643-5511 x3268
Fax #: (405) 643-9943
County: CADDO
License: 247
Dated: 1/5/2000
Expires: 8/31/2018
Temp. Ltr. Issued: 11/19/1999
Temp. Ltr. Expires: 1/31/2000
License Type: Athletic Trainer
Specialty:
Status: Active
Status Class: Fully Licensed
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:
CADDO-KIOWA TECH CENTER
PO BOX 190
FORT COBB OK 73038

Phone #: (405) 643-5511 x3268
Fax #: (405) 643-9943

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