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Once completed, this Agreement is to be ... - Oklahoma
nursing.ok.gov2. Oklahoma License Number Expiration Date 3. Work Address Street City State Zip Telephone # 4. Practice Specialty Area National Certification Board If not certified, write “none.” 5. Do you have an unrestricted license from the Oklahoma Board of Medical Licensure and Supervision or from the Oklahoma State
Oklahoma Board of Medical Licensure and …
www.okmedicalboard.orgOklahoma Board of Medical Licensure and Supervision 101 NE 51st Street, Oklahoma City, OK 73105 PO Box 18256, Oklahoma City, OK 73154-0256 Main Number – (405)-962-1400 Ext. 118 Fax – 405-962-1499