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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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EKISS, KEVIN MARK       
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
GUTHRIE OK 73044

Address last updated on 9/26/2024
Phone #:
Fax #:
County: LOGAN
License: 604
Dated: 3/19/1994
Expires: 10/31/2025
Temp. Ltr. Issued: 1/13/1994
Temp. Ltr. Expires: 3/19/1994
License Type: Occupational Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
3/24/2008 Probation Ended
3/22/2007 Probation
2/2/2007 Complaint Citation
Board Filings and/or Orders:
03/22/2007
01/25/2007
01/25/2007
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
SYNERGY CARE
GUTHRIE OK 73044

Phone #:
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
OU-KHAM CHANSOMBATH OA 1308
TAURIE SHAMPAIGNE HAMPTON OA 2524
ASHLEY JADE LUCAS OA 2563
AMBER DAWN TAYLOR OA 708
JESSICA RAE WADDLE OA 2069

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