PEARSON, CLARK DOUGLAS - Licensee Information

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PEARSON, CLARK DOUGLAS

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:	UNIVERSITY OF WISCONSIN HEAD FOOTBALL ATHLETIC TRAINER 1440 MONROE STREET MADISON WI 53711 Address last updated on 6/17/2005
Phone #:	(608) 262-8038
Fax #:	(608) 265-4736
County:	NOT OKLAHOMA
License:	186
Dated:	11/20/1997
Expires:	8/31/2005
Temp. Ltr. Issued:	10/23/1997
Temp. Ltr. Expires:	11/22/1997
License Type:	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:
UNIVERSITY OF WISCONSIN HEAD FOOTBALL ATHLETIC TRAINER 1440 MONROE STREET MADISON WI 53711 Phone #: (608) 262-8038 Fax #: (608) 265-4736

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