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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, December 24, 2024 6:44 PM CST
Next Update: Wednesday, December 25, 2024 2:50 AM CST

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GERLT, TODD RYAN       
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: OKLAHOMA STATE UNIVERSITY
170 ATHLETICS CENTER
STILLWATER OK 74078

Address last updated on 8/26/2024
Phone #: (405) 744-7416
Fax #:
County: PAYNE
License: 512
Dated: 10/5/2007
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:
OKLAHOMA STATE UNIVERSITY
170 ATHLETICS CENTER
STILLWATER OK 74078

Phone #: (405) 744-7416
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
VAL GENE IVEN MD 17462
Jason R. Moore DO 6450

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