CHURCHILL, CARISSA LEE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

CHURCHILL, CARISSA LEE

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:	7000 NORTHWEST EXPRESSWAY SUITE C 7000 OKLAHOMA CITY OK 73132 Address last updated on 12/7/2023
Phone #:	(405) 840-1957
Fax #:
County:	OKLAHOMA
License:	3369
Dated:	5/24/2021
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:
7000 NORTHWEST EXPRESSWAY SUITE C 7000 OKLAHOMA CITY OK 73132 Phone #: (405) 840-1957 Fax #:

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