TechDetail

Last Updated:  5/3/2026 7:29:07 PM

Technician Detail               
Name  SOUTHIDA   PHANTHAVONG 
Type  Technician 
Number 11901 
City  OKLAHOMA CITY, OK  73120 
Status CANCELED
Issue Date  03/19/2008 
Renewed Date 03/20/2008
Expire Date  01/31/2009 
End Date  03/02/2009 

Immunization?

No 
 

Disciplinary Action
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Case Date   Case Number  
No Disciplinary Action