MANLY, TARA LAURINE - Licensee Information

Search Results

Last Update: Friday, April 19, 2024 3:56 AM CDT
Next Update: Friday, April 19, 2024 12:00 PM CDT

MANLY, TARA LAURINE

Practice Address:	THE BROADWAY CLINIC 1801 N BROADWAY AVENUE OKLAHOMA CITY OK 73103 Address last updated on 6/25/2009
Phone #:	(405) 528-1936
Fax #:
County:	OKLAHOMA
License:	1755
Dated:	10/17/2008
Expires:	3/31/2010
Temp. Ltr. Issued:	7/18/2008
Temp. Ltr. Expires:	11/7/2008
License Type:	Physician Assistant
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:
THE BROADWAY CLINIC 1801 N BROADWAY AVENUE OKLAHOMA CITY OK 73103 Phone #: (405) 528-1936 Fax #:

Hospital Privileges:

None listed

Return to Search Licensees page

GDPR Notice

European Union Residents - GDPR Notice: In accordance with the Oklahoma Open Records Act, all applications submitted are a matter of public record. Social Security Numbers and any HIPAA-protected data are redacted. By applying for and retaining an Oklahoma Medical License, you are giving consent to share your information with anyone requesting it and waiving your right to be notified when your data is requested. We are also required to retain licensee records for a minimum of 10 years after the license expires, so any information submitted will remain a public record for that time period.

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
Contact Info