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MILLSAP, SHALEY KRISTINE       
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: NWOSU Athletic Training
709 Oklahoma Blvd.
Alva OK 73717

Address last updated on 6/11/2011
Phone #: (580) 327-8627
Fax #:
County: WOODS
License: 535
Dated: 9/15/2011
Expires: 8/31/2012
Temp. Ltr. Issued: 8/12/2011
Temp. Ltr. Expires: 9/16/2011
License Type: Apprentice Athletic Trainer
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 0
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:
NWOSU Athletic Training
709 Oklahoma Blvd.
Alva OK 73717

Phone #: (580) 327-8627
Fax #:

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