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Get OK ODH 924 2018

PICE AGENCY 1. APPLICATION TYPE & LICENSE FEE: No such fee shall be refunded. License fee must accompany the application. Checks, money orders, or bank drafts must be made payable to OKLAHOMA STATE DEPARTMENT OF HEALTH and mailed with your completed application. OKLAHOMA STATE DEPARTMENT OF HEALTH FINANCIAL MANAGEMENT RECEIPTING UNIT PO BOX 268823 OKLAHOMA CITY, OK 73126-8823 $ 2000.00 $ 2000.00 $ 50.00 $ 500.00 $ 2000.00 Initial License & Application Fee Renewal License Fee License #: _____.

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