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Oklahoma Board of Medical Licensure and Supervision

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MALLORY, NICOLE DANIELLE       
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: TODAY CLINIC
701 NE 36TH STREET
OKLAHOMA CITY OK 73105

Address last updated on 3/3/2016
Phone #: (405) 631-0611
Fax #:
County: OKLAHOMA
License: 2292
Dated: 10/28/2013
Expires: 3/31/2017
Temp. Ltr. Issued: 8/30/2013
Temp. Ltr. Expires: 11/8/2013
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2017
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:
TODAY CLINIC
701 NE 36TH STREET
OKLAHOMA CITY OK 73105

Phone #: (405) 631-0611
Fax #:

Hospital Privileges:

None listed

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