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Oklahoma Board of Medical Licensure and Supervision

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MALLORY, NICOLE DANIELLE
Practice Address: TODAY CLINIC
701 NE 36TH STREET
OKLAHOMA CITY OK 73105

Address last updated on 3/3/2016
Phone #: (405) 631-0611
Fax #:
County: OKLAHOMA
License: 2292
Dated: 10/28/2013
Expires: 3/31/2017
Temp. Ltr. Issued: 8/30/2013
Temp. Ltr. Expires: 11/8/2013
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2017
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:
TODAY CLINIC
701 NE 36TH STREET
OKLAHOMA CITY OK 73105

Phone #: (405) 631-0611
Fax #:

Hospital Privileges:

None listed

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