JEZEK, CATHERINE GRACE - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

JEZEK, CATHERINE GRACE

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:	THE GRIFFIN PROMISE AUTISM CLINIC 3100 S ELM PL #A BROKEN ARROW OK 74012 Address last updated on 10/1/2024
Phone #:	(918) 893-3735
Fax #:
County:	TULSA
License:	2399
Dated:	2/9/2022
Expires:	10/31/2025
Temp. Ltr. Issued:	11/29/2021
Temp. Ltr. Expires:	3/10/2022
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:
THE GRIFFIN PROMISE AUTISM CLINIC 3100 S ELM PL #A BROKEN ARROW OK 74012 Phone #: (918) 893-3735 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
EMILY RENEE VERNON	OT	1710

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