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Oklahoma Board of Medical Licensure and Supervision

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WALLACE, DANYEL JOE       
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: MIDWEST REGIONAL MED CTR
2825 PARKLAWN DRIVE
MIDWEST CITY OK 73110-4201

Address last updated on 1/31/2001
Phone #: (405) 610-8094
Fax #:
County: OKLAHOMA
License: 875
Dated: 8/11/2000
Expires: 1/31/2006
License Type: Physical Therapist Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
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:
MIDWEST REGIONAL MED CTR
2825 PARKLAWN DRIVE
MIDWEST CITY OK 73110-4201

Phone #: (405) 610-8094
Fax #:

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