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Oklahoma Board of Medical Licensure and Supervision

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DAVIS, MELISSA ANN       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: NORTHEASTERN STATE UNIVERSITY
603 N GRAND
TAHLEQUAH OK 74464

Address last updated on 8/30/2006
Phone #: (918) 456-5511 x3921
Fax #:
County: CHEROKEE
License: 290
Dated: 11/8/2001
Expires: 8/31/2002
Temp. Ltr. Issued: 10/12/2001
Temp. Ltr. Expires: 11/10/2001
License Type: Apprentice Athletic Trainer
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
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:
NORTHEASTERN STATE UNIVERSITY
603 N GRAND
TAHLEQUAH OK 74464

Phone #: (918) 456-5511 x3921
Fax #:

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