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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, May 6, 2024 12:17 PM CDT
Next Update: Monday, May 6, 2024 4:30 PM CDT

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MITWALLI, MAISSA BAKER
Practice Address: THE ORTHOPEDIC CENTER
1809 EAST 13TH ST
TULSA OK 74104

Address last updated on 3/5/2024
Phone #:
Fax #:
County: TULSA
License: 4400
Dated: 11/4/2020
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
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 ORTHOPEDIC CENTER
1809 EAST 13TH ST
TULSA OK 74104

Phone #:
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
YOGESH MITTAL MD 23844

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