Last Updated: 12/20/2025 7:09:23 PM
Technician Detail| Name | LATASHA TANARA WALLACE |
| Type | Technician |
| Number | 16213 |
| City | BROKEN ARROW, OK 74012 |
| Status | CANCELED |
| Issue Date | 01/13/2012 |
| Renewed Date | 10/09/2019 |
| Expire Date | 06/30/2020 |
| End Date | 08/01/2020 |
|
Immunization? |
No |
Disciplinary
Action
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| Case Date | Case Number |
| No Disciplinary Action | |
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