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Last Update: Saturday, April 27, 2024 4:04 AM CDT
Next Update: Saturday, April 27, 2024 12:00 PM CDT
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WATKINS, KELLY DAWN |
| Practice Address: |
ACTIVE LIFESTYLE MEDICAL
5455 S MINGO RD
TULSA OK 74146
Address last updated on 1/19/2024 |
| Phone #: |
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| Fax #: |
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| County: |
TULSA |
| License: |
169 |
| Dated: |
11/1/2021 |
| Expires: |
1/31/2025 |
|
Temp.
Ltr.
Issued:
|
5/25/2021 |
|
Temp.
Ltr.
Expires:
|
11/18/2021 |
| License Type: |
Licensed Pedorthist |
| Specialty: |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| CME Year: |
0 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Primary Supervisor(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
|
ROBBIE LYNN ELY
|
LPED |
138 |
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