TechDetail

Last Updated:  5/17/2024 7:04:46 PM

Technician Detail               
Name  CODY LANE  ICEBERG 
Type  Technician 
Number 21847 
City  TALALA, OK  74080 
Status CANCELED
Issue Date  06/24/2016 
Renewed Date 06/28/2016
Expire Date  08/31/2016 
End Date  09/30/2016 

Immunization?

No 
 

Disciplinary Action
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Case Date   Case Number  
No Disciplinary Action