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Oklahoma Board of Medical Licensure and Supervision

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

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ELY, ROBBIE LYNN       
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: ACTIVE LIFESTYLE MEDICAL LLC
5455 S MINGO RD, STE E
TULSA OK 74146

Address last updated on 1/6/2023
Phone #: (918) 576-6765
Fax #:
County: TULSA
License: 138
Dated: 2/1/2013
Expires: 1/31/2025
License Type: Licensed Pedorthist
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:
ACTIVE LIFESTYLE MEDICAL LLC
5455 S MINGO RD, STE E
TULSA OK 74146

Phone #: (918) 576-6765
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KELLY DAWN WATKINS LPED 169

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