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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Saturday, May 4, 2024 2:50 AM CDT

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STACK, HOLLY LUANNE
Practice Address: MEDICALODGE
HWY 123
DEWEY OK 74029

Address last updated on 12/23/1999
Phone #:
Fax #:
County: WASHINGTON
License: 669
Dated: 5/1/1998
Expires: 1/31/2000
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:
MEDICALODGE
HWY 123
DEWEY OK 74029

Phone #:
Fax #:

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