WALLACE, AMBER BREANNA - Licensee Information

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WALLACE, AMBER BREANNA

Practice Address:	INTEGRIS GROVE GENERAL HOSPITAL 1310 SOUTH MAIN GROVE OK 74345 Address last updated on 12/15/2000
Phone #:
Fax #:
County:	DELAWARE
License:	562
Dated:	3/6/2001
Expires:	9/30/2001
Temp. Ltr. Issued:	12/21/2000
Temp. Ltr. Expires:	3/17/2001
License Type:	Provisional Respiratory Care
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:
INTEGRIS GROVE GENERAL HOSPITAL 1310 SOUTH MAIN GROVE OK 74345 Phone #: Fax #:

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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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