PITTS, MODANA LYNN - Licensee Information

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PITTS, MODANA LYNN

Practice Address:	SOUTHWEST MEDICAL CENTER 4401 SOUTH WESTERN OKLAHOMA CITY OK 73109-3441 Address last updated on 9/20/2013
Phone #:	(405) 636-7070
Fax #:
County:	OKLAHOMA
License:	815
Dated:	6/15/2004
Expires:	6/30/2005
Temp. Ltr. Issued:	4/8/2004
Temp. Ltr. Expires:	6/25/2004
License Type:	Provisional Respiratory Care
Specialty:

Status:	Inactive
Status Class:	Expired License
Restricted to:
CME Year:	0

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:
SOUTHWEST MEDICAL CENTER 4401 SOUTH WESTERN OKLAHOMA CITY OK 73109-3441 Phone #: (405) 636-7070 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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