GANNAWAY, MALLERY GRAY - Licensee Information

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Last Update: Monday, April 29, 2024 7:03 PM CDT
Next Update: Tuesday, April 30, 2024 2:50 AM CDT

GANNAWAY, MALLERY GRAY

Practice Address:	SMM HEALTH BONE & JOINT HOSPITAL 1111 N DEWEY AVE OKLAHOMA CITY OK 73103 Address last updated on 7/17/2023
Phone #:
Fax #:
County:	OKLAHOMA
License:	1125
Dated:	9/1/2019
Expires:	8/31/2024
Temp. Ltr. Issued:	5/30/2019
Temp. Ltr. Expires:	9/12/2019
License Type:	Athletic Trainer
Specialty:

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:
SMM HEALTH BONE & JOINT HOSPITAL 1111 N DEWEY AVE OKLAHOMA CITY OK 73103 Phone #: Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
JOHN LARSON GLOMSET III	MD	29497