CLARK, TRACY S - Licensee Information - Oklahoma Medical Board

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Last Update: Saturday, May 4, 2024 6:58 PM CDT
Next Update: Sunday, May 5, 2024 2:50 AM CDT

CLARK, TRACY S

Practice Address:	MINDBLOOM 619 W. MAIN STREET OKLAHOMA CITY OK 73102-2221 Address last updated on 9/27/2022
Phone #:	(929) 274-0518
Fax #:
County:	OKLAHOMA
License:	4954
Dated:	4/1/2023
Expires:	3/31/2024
License Type:	Physician Assistant
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	2024

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:
MINDBLOOM 619 W. MAIN STREET OKLAHOMA CITY OK 73102-2221 Phone #: (929) 274-0518 Fax #:

Hospital Privileges:

None listed

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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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