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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, December 24, 2024 1:13 PM CST
Next Update: Tuesday, December 24, 2024 4:30 PM CST

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GADDIS, RAVEN SYMONE       
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: 9201 S SOONER ROAD
OKLAHOMA CITY OK 73165

Address last updated on 12/8/2023
Phone #:
Fax #:
County: OKLAHOMA
License: 5788
Dated: 3/1/2021
Expires: 1/31/2025
Temp. Ltr. Issued: 7/2/2020
Temp. Ltr. Expires: 11/23/2020
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:
9201 S SOONER ROAD
OKLAHOMA CITY OK 73165

Phone #:
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
DULCIA ADALINA IDALLE COMBS-RICHARDSON TA 2044
ROBERT JOHN SPENCER TA 2168

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