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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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CHANSOMBATH, OU-KHAM       
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: SYNERGY CARE
419 E OKLAHOMA
GUTHRIE OK 73044

Address last updated on 10/22/2024
Phone #: (405) 820-9344
Fax #:
County: LOGAN
License: 1308
Dated: 11/14/2013
Expires: 10/31/2025
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
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:
SYNERGY CARE
419 E OKLAHOMA
GUTHRIE OK 73044

Phone #: (405) 820-9344
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
STACY MARIE BRITTON OT 1712
KIM DUNG DOAN OT 1579
KEVIN MARK EKISS OT 604
HUONG KIM HOANG OT 1678
CLINTON JOSEPH SCHOLZ OT 1844

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