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Oklahoma Board of Medical Licensure and Supervision

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COOPER, JUSTIN MARK       
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: CENTRAL STATES ORTHOPEDIC SPECIALISTS
505 S ASPEN AVE
BROKEN ARROW OK 74012

Address last updated on 3/30/2013
Phone #: (918) 994-5333
Fax #:
County: TULSA
License: 4311
Dated: 7/9/2010
Expires: 1/31/2014
Temp. Ltr. Issued: 5/29/2010
Temp. Ltr. Expires: 9/16/2010
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:
CENTRAL STATES ORTHOPEDIC SPECIALISTS
505 S ASPEN AVE
BROKEN ARROW OK 74012

Phone #: (918) 994-5333
Fax #:

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