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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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AGCAOILI, GUNNAR ALAN       
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: 564 STATELINE RD
COLCORD OK 74338

Address last updated on 12/16/2024
Phone #: (918) 422-5138
Fax #: (918) 422-6279
County: DELAWARE
License: 1393
Dated: 5/5/2005
Expires: 1/31/2025
License Type: Physical Therapist Assistant
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:
564 STATELINE RD
COLCORD OK 74338

Phone #: (918) 422-5138
Fax #: (918) 422-6279
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ANDRES RENE ZAMBRANO PT 4331

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