ELDRIDGE, CRYSTAL WYNELL - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
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ELDRIDGE, CRYSTAL WYNELL

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:	IMAGINE PEDIATRIC THERAPY 12899 E. 76TH ST. N. SUITE 109 OWASSO OK 74055 Address last updated on 1/9/2018
Phone #:	(918) 609-6003
Fax #:
County:	TULSA
License:	3922
Dated:	7/13/2006
Expires:	1/31/2019
Temp. Ltr. Issued:	6/1/2006
Temp. Ltr. Expires:	9/23/2006
License Type:	Physical Therapist
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	2020

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:
IMAGINE PEDIATRIC THERAPY 12899 E. 76TH ST. N. SUITE 109 OWASSO OK 74055 Phone #: (918) 609-6003 Fax #:

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