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Oklahoma Board of Medical Licensure and Supervision

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MARCUM, CARMEN LARAE       
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: BROCKTON PHYSICAL THERAPY
3908 10TH ST
RIVERSIDE CA 92501

Address last updated on 12/28/2011
Phone #: (405) 788-8097
Fax #:
County: NOT OKLAHOMA
License: 2952
Dated: 10/22/1999
Expires: 1/31/2013
Temp. Ltr. Issued: 7/15/1999
Temp. Ltr. Expires: 2/29/2000
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2014
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:
BROCKTON PHYSICAL THERAPY
3908 10TH ST
RIVERSIDE CA 92501

Phone #: (405) 788-8097
Fax #:

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