CLARK, JONATHAN DAVID - Licensee Information

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Last Update: Thursday, April 25, 2024 10:24 AM CDT
Next Update: Thursday, April 25, 2024 12:00 PM CDT

CLARK, JONATHAN DAVID

Practice Address:	EASTERN OK AVE HEALTH CARE SP 1011 HONOR HEIGHT DR MUSKOGEE OK 74401 Address last updated on 2/16/2024
Phone #:	(918) 577-4164
Fax #:
County:	MUSKOGEE
License:	776
Dated:	9/5/2013
Expires:	1/30/2021
Temp. Ltr. Issued:	6/14/2013
Temp. Ltr. Expires:	9/12/2013
License Type:	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:
EASTERN OK AVE HEALTH CARE SP 1011 HONOR HEIGHT DR MUSKOGEE OK 74401 Phone #: (918) 577-4164 Fax #:

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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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