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Last Update: Friday, May 3, 2024 4:08 PM CDT
Next Update: Saturday, May 4, 2024 2:50 AM CDT
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|
CLARK, COULTER LOUIS |
| Practice Address: |
2400 W. BROADWAY STREET
COLLINSVILLE OK 74021
Address last updated on 8/23/2023 |
| Phone #: |
(580) 548-3283 |
| Fax #: |
|
| County: |
OKLAHOMA |
| License: |
673 |
| Dated: |
2/17/2012 |
| Expires: |
8/31/2024 |
|
Temp.
Ltr.
Issued:
|
10/14/2011 |
|
Temp.
Ltr.
Expires:
|
3/23/2012 |
| License Type: |
Athletic Trainer |
| Specialty: |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| CME Year: |
0 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Primary Supervisor(s):
|
| Name: |
Type: |
License Number: |
Full/Part Time: |
|
JAY DARIN LORTON
|
MD |
19839 |
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