TechDetail

Last Updated:  5/4/2024 5:19:28 AM

Technician Detail               
Name  MISTY D  FORTIN 
Type  Technician 
Number 23539 
City  CARTER, OK  73627 
Status CANCELED
Issue Date  12/01/2017 
Renewed Date 12/01/2017
Expire Date  06/30/2018 
End Date  07/30/2018 

Immunization?

No 
 

Disciplinary Action
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Case Date   Case Number  
No Disciplinary Action