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Oklahoma Board of Medical Licensure and Supervision

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EASLEY, MACK CARL       
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: 501 N 4TH ST
MARLOW OK 73055

Address last updated on 3/24/2011
Phone #:
Fax #:
County: STEPHENS
License: 354
Dated: 5/24/1982
Expires: 3/31/1986
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Void
Restricted to:
CME Year:
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:
501 N 4TH ST
MARLOW OK 73055

Phone #:
Fax #:

Hospital Privileges:

None listed

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