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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, April 26, 2024 11:33 AM CDT
Next Update: Friday, April 26, 2024 4:30 PM CDT

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CAUDILLO, SHANNON RENE'
Practice Address: PARC PLACE MEDICAL RESORT-POWERBACK REHAB
4200 EAST MEMORIAL RD
OKLAHOMA CITY OK 73131

Address last updated on 10/22/2023
Phone #: (405) 875-0040
Fax #:
County: OKLAHOMA
License: 1198
Dated: 11/4/2010
Expires: 10/31/2024
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2024
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:
PARC PLACE MEDICAL RESORT-POWERBACK REHAB
4200 EAST MEMORIAL RD
OKLAHOMA CITY OK 73131

Phone #: (405) 875-0040
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
TIFFANY BROOKE ADAMS OT 5321

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