WALLACE, KACIE NICOLE - Licensee Information

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Last Update: Sunday, April 28, 2024 1:44 PM CDT
Next Update: Sunday, April 28, 2024 4:30 PM CDT

WALLACE, KACIE NICOLE

Practice Address:	No Current Practice Address Address last updated on 6/9/2022
Phone #:
Fax #:
County:	NOT OKLAHOMA
License:	3181
Dated:	6/8/2020
Expires:	3/30/2022
License Type:	Physician Assistant
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	2022

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:
No Current Practice Address Phone #: Fax #:

Hospital Privileges:

None listed

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European Union Residents - GDPR Notice: In accordance with the Oklahoma Open Records Act, all applications submitted are a matter of public record. Social Security Numbers and any HIPAA-protected data are redacted. By applying for and retaining an Oklahoma Medical License, you are giving consent to share your information with anyone requesting it and waiving your right to be notified when your data is requested. We are also required to retain licensee records for a minimum of 10 years after the license expires, so any information submitted will remain a public record for that time period.

Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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