MOORE, MARK WILBURN - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

MOORE, MARK WILBURN

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:	CONCENTRA PHYSICAL THERAPY 801 POINDEXTER STREET SUITE 218 CHESAPEAKE VA 23324 Address last updated on 1/23/2024
Phone #:
Fax #:
County:	NOT OKLAHOMA
License:	3598
Dated:	9/3/2002
Expires:	1/31/2024
Temp. Ltr. Issued:	11/29/2021
Temp. Ltr. Expires:	1/20/2022
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:
CONCENTRA PHYSICAL THERAPY 801 POINDEXTER STREET SUITE 218 CHESAPEAKE VA 23324 Phone #: Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
CHERIE JEAN ANDERSON	TA	3612

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