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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, April 24, 2024 4:32 AM CDT
Next Update: Wednesday, April 24, 2024 12:00 PM CDT

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GENTRY, SUSAN RENEE'
Practice Address: GRAND LAKE VILLA
103 HARBER ROAD
GROVE OK 74344

Address last updated on 1/9/2024
Phone #: (918) 786-2276
Fax #: (918) 786-2277
County: DELAWARE
License: 3090
Dated: 10/26/2000
Expires: 1/31/2025
Temp. Ltr. Issued: 3/10/2005
Temp. Ltr. Expires: 5/5/2005
License Type: Physical Therapist
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:
GRAND LAKE VILLA
103 HARBER ROAD
GROVE OK 74344

Phone #: (918) 786-2276
Fax #: (918) 786-2277
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
LISA K EAST TA 1762
MICAH JEROD LITTLEJOHN TA 1741

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