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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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BONAOBRA, ROGER MAGTANGOB       
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: 111 S YORK ST.
MUSKOGEE OK 74403

Address last updated on 1/30/2024
Phone #: (918) 682-6202
Fax #:
County: OKLAHOMA
License: 2192
Dated: 6/30/1994
Expires: 1/31/2025
Temp. Ltr. Issued: 10/14/1993
Temp. Ltr. Expires: 7/23/1994
License Type: Physical Therapist
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:
111 S YORK ST.
MUSKOGEE OK 74403

Phone #: (918) 682-6202
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ROBERT COLE BENNETT TA 2924
CHRISTOPHER THOMAS CAMPBELL TA 1098
ABIGAIL ANN COX TA 2927
BECCA SHAY COX TA 1173
JOE C DALMUT JR TA 1385
DEVYN RYON DAVIS TA 3142
CASEY EVAN DEWBRE TA 2333
KIMBERLY ANN GREGG TA 2275
KATY HARPER TA 3212
GRADY ANDREW HIGGINBOTHAM TA 3417
JEREMY GENE HODGES TA 2550
JODI LEEANN JONES TA 2787
ERIN ELIZABETH MINER TA 1578
KAILY N MITCHELL TA 2935
DAMON MATHEW MOORMAN TA 501
SUSANNE MARIE MOSKAL TA 2410
CORINNE MARIE PERKINS TA 2085
PHYLLIS MARJAN ROSSON TA 922
BRETT GENE SMITH TA 2940
CANDI LOUISE SPEARS TA 705
TRACEY JEAN SZABO TA 1440
JESSICA LEEANN TAYLOR TA 2542
PABLO TIENDA JR. TA 2648

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