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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, March 28, 2023 9:27 AM CDT
Next Update: Tuesday, March 28, 2023 12:00 PM CDT

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WALLACE, THOMAS FOSTER JR
Practice Address: CHICASAW NATION MEDICAL CENTER
1921 STONECIPHER BLVD
ADA OK 74820

Address last updated on 7/2/2021
Phone #: (580) 436-3980
Fax #:
County: PONTOTOC
License: 2836
Dated: 7/26/2007
Expires: 7/31/2023
Temp. Ltr. Issued: 2/22/2007
Temp. Ltr. Expires: 9/22/2007
License Type: Respiratory Care Practitioner
Specialty:
Status: Active
Status Class: Fully Licensed
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:
CHICASAW NATION MEDICAL CENTER
1921 STONECIPHER BLVD
ADA OK 74820

Phone #: (580) 436-3980
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TANISHA RENA THOMPSON RC 4774

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