Last Updated: 12/23/2024 5:22:52 AM
Facility DetailCorporation / Company Owner Name | |
Business (DBA) Name | INDIAN TERRITORY DME |
License Number | 65-S-1100 |
Facility Type | Medical Gas Supplier |
Address |
112 N BROADWAY |
City, State, Zip | WALTERS,OK 73572-1258 |
Country | |
Issue Date | 02/23/2005 |
Renewed Date | 01/25/2007 |
Expiration Date | 02/29/2008 |
Renewal Month | |
End Date | 01/09/2008 |
Status | CLOSED |
In Process? | |
Disciplinary
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