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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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ANCIK, MELISSA RAE       
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: 9201 W CO RD 76
CONTRACTOR
CRESCENT OK 73028-9407

Address last updated on 2/18/2022
Phone #: (405) 760-5497
Fax #:
County: LOGAN
License: 2526
Dated: 8/15/1996
Expires: 1/31/2023
Temp. Ltr. Issued: 5/16/1996
Temp. Ltr. Expires: 9/28/1996
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2024
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:
9201 W CO RD 76
CONTRACTOR
CRESCENT OK 73028-9407

Phone #: (405) 760-5497
Fax #:

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