TechDetail

Last Updated:  5/5/2024 5:21:49 AM

Technician Detail               
Name  SHELBY   PRUDENCIO 
Type  Technician 
Number 30092 
City  LAWTON, OK  73503 
Status License in Good Standing
Issue Date  04/14/2023 
Renewed Date 04/14/2023
Expire Date  04/30/2024 
End Date   

Immunization?

No 
 

Disciplinary Action
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Case Date   Case Number  
No Disciplinary Action