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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, April 26, 2024 7:06 PM CDT
Next Update: Saturday, April 27, 2024 2:50 AM CDT

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EAST, LISA K
Practice Address: GRAND LAKE VILLA
103 WEST HARBOR ROAD
GROVE OK 74344

Address last updated on 1/9/2024
Phone #: (918) 786-2276
Fax #:
County: DELAWARE
License: 1762
Dated: 2/1/2009
Expires: 1/31/2025
Temp. Ltr. Issued: 10/31/2008
Temp. Ltr. Expires: 1/30/2009
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:
GRAND LAKE VILLA
103 WEST HARBOR ROAD
GROVE OK 74344

Phone #: (918) 786-2276
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
SUSAN RENEE' GENTRY PT 3090

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