MALLORY, JULIE ANN - Licensee Information

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Last Update: Friday, April 19, 2024 8:43 AM CDT
Next Update: Friday, April 19, 2024 12:00 PM CDT

MALLORY, JULIE ANN

Practice Address:	31413 HIGHWAY NINE TECUMSEH OK 74873-5523 Address last updated on 9/4/2023
Phone #:
Fax #:
County:	POTTAWATOMIE
License:	693
Dated:	1/11/1992
Expires:	10/31/2024
Temp. Ltr. Issued:	10/3/1991
Temp. Ltr. Expires:	1/11/1992
License Type:	Licensed Dietitian
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:

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:
31413 HIGHWAY NINE TECUMSEH OK 74873-5523 Phone #: Fax #:

Name:	Type:	License Number:
Primary Supervisees(s):
DESTINY NOEL HOWARD	PD	696
AISA M TRICE	PD	712

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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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