LEATHERMAN, MYLIE BROOKE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

LEATHERMAN, MYLIE BROOKE

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:	PRYOR PUBLIC SCHOOLS 1100 SE 9TH STREET PRYOR OK 74362 Address last updated on 9/10/2024
Phone #:	(918) 825-1255
Fax #:
County:	MAYES
License:	1035
Dated:	9/28/2018
Expires:	8/31/2025
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
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:
PRYOR PUBLIC SCHOOLS 1100 SE 9TH STREET PRYOR OK 74362 Phone #: (918) 825-1255 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
DARIN GWARTNEY	DO	5219

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