RANALLO, AMANDA MARIE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

RANALLO, AMANDA MARIE

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	LIFE SENIOR SERVICES / PACE PROGRAM 4821 S 72ND E AVE TULSA OK 74145 Address last updated on 12/13/2024
Phone #:	(918) 794-1565
Fax #:
County:	TULSA
License:	1336
Dated:	9/30/2004
Expires:	1/31/2025
Temp. Ltr. Issued:	8/13/2004
Temp. Ltr. Expires:	11/4/2004
License Type:	Physical Therapist Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
LIFE SENIOR SERVICES / PACE PROGRAM 4821 S 72ND E AVE TULSA OK 74145 Phone #: (918) 794-1565 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
KATHERINE JUNE CODY	PT	4341

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