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Oklahoma Board of Medical Licensure and Supervision

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ELLIOTT, JESSE CLARK       
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: 6907 E 61ST PL
TULSA OK 74133
Phone #:
Fax #:
County: TULSA
License: 15
Dated: 9/22/1965
Expires: 1/31/1989
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Deceased
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:
6907 E 61ST PL
TULSA OK 74133

Phone #:
Fax #:

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