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STILWAGEN, MALIA JADE       
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: NORTHERN THERAPY & REHAB
2005 N 14TH #111
PONCA CITY OK 74602-0908
Phone #:
Fax #:
County: KAY
License: 231
Dated: 5/10/1999
Expires: 8/31/1999
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:
NORTHERN THERAPY & REHAB
2005 N 14TH #111
PONCA CITY OK 74602-0908

Phone #:
Fax #:

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