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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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ITEN, MICHAEL JEROME       
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: WC SPRINGER CLINIC UC
6160 S YALE AVE
TULSA OK 74136

Address last updated on 5/29/2024
Phone #: (918) 495-2600
Fax #: (918) 497-3007
County: TULSA
License: 1478
Dated: 3/10/2006
Expires: 1/31/2014
Temp. Ltr. Issued: 1/5/2006
Temp. Ltr. Expires: 5/13/2006
License Type: Physical Therapist Assistant
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:
WC SPRINGER CLINIC UC
6160 S YALE AVE
TULSA OK 74136

Phone #: (918) 495-2600
Fax #: (918) 497-3007

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