WALLACE, LAUREN - Licensee Information

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Last Update: Sunday, April 28, 2024 6:57 PM CDT
Next Update: Monday, April 29, 2024 2:50 AM CDT

WALLACE, LAUREN

Practice Address:	1 CLARK BASS BLVD. STE. 201 MCALESTER OK 74501 Address last updated on 2/26/2024
Phone #:
Fax #:
County:	PITTSBURG
License:	4427
Dated:	12/17/2020
Expires:	3/31/2025
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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:
1 CLARK BASS BLVD. STE. 201 MCALESTER OK 74501 Phone #: Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
PATRICK RUSSELL GANNON	MD	20652

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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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