TechDetail

Last Updated:  5/18/2024 7:05:42 PM

Technician Detail               
Name  WAFFEL MADISON  BERG 
Type  Technician 
Number 21561 
City  CHOCTAW, OK  73020 
Status CANCELED
Issue Date  03/31/2016 
Renewed Date 04/04/2016
Expire Date  03/31/2017 
End Date  04/30/2017 

Immunization?

No 
 

Disciplinary Action
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Case Date   Case Number  
No Disciplinary Action