WALLACE, SHUNTAE N - Licensee Information

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Last Update: Friday, April 19, 2024 6:57 PM CDT
Next Update: Saturday, April 20, 2024 2:50 AM CDT

WALLACE, SHUNTAE N

Practice Address:	BETHANY CHILDREN'S HEALTH CENTER 6800 NW 39TH EXPY BETHANY OK 73008 Address last updated on 10/7/2022
Phone #:	(405) 789-6711
Fax #:
County:	OKLAHOMA
License:	6084
Dated:	12/8/2022
Expires:	12/31/2024
Temp. Ltr. Issued:	10/26/2022
Temp. Ltr. Expires:	1/19/2023
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:
BETHANY CHILDREN'S HEALTH CENTER 6800 NW 39TH EXPY BETHANY OK 73008 Phone #: (405) 789-6711 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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