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WATT, SHANNON MARIE
Practice Address: 175 SUMMERALL ROAD
FORT DIX NJ 08640

Address last updated on 12/23/1999
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 542
Dated: 2/3/1997
Expires: 1/31/2000
Temp. Ltr. Issued: 12/5/1996
Temp. Ltr. Expires: 3/15/1997
License Type: Physical Therapist Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
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:
175 SUMMERALL ROAD
FORT DIX NJ 08640

Phone #:
Fax #:

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