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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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MALLOY, SAMONE       
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: ST. JOHN SAPULPA
1004 E BRYAN
SAPULPA OK 74066

Address last updated on 1/26/2024
Phone #: (918) 227-8607
Fax #: (918) 224-9227
County: CREEK
License: 4695
Dated: 11/7/2013
Expires: 1/31/2025
Temp. Ltr. Issued: 9/26/2013
Temp. Ltr. Expires: 1/16/2014
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
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:
ST. JOHN SAPULPA
1004 E BRYAN
SAPULPA OK 74066

Phone #: (918) 227-8607
Fax #: (918) 224-9227
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SUSAN ELAINE MARTIN TA 822
SUSAN ELAINE MARTIN TA 822

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