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JACKSON, CHARLES MACK JR
Practice Address: ST JOHN SPORTS AND PT
4808 S. 109TH E. AVE.
TULSA OK 74146

Address last updated on 1/10/2012
Phone #: (918) 712-1182
Fax #:
County: TULSA
License: 2559
Dated: 9/12/1996
Expires: 1/31/2013
Temp. Ltr. Issued: 5/23/1996
Temp. Ltr. Expires: 9/27/1996
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2014
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:
ST JOHN SPORTS AND PT
4808 S. 109TH E. AVE.
TULSA OK 74146

Phone #: (918) 712-1182
Fax #:

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