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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, September 26, 2024 1:21 PM CDT
Next Update: Thursday, September 26, 2024 4:30 PM CDT

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JACKSON, KYLEE RENE'       
Practice Address: 927 N 5TH ST
PONCA CITY OK 74601

Address last updated on 8/20/2024
Phone #:
Fax #:
County: KAY
License: 584
Dated: 9/13/2012
Expires: 8/31/2015
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:
927 N 5TH ST
PONCA CITY OK 74601

Phone #:
Fax #:

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