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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, April 24, 2024 3:08 PM CDT
Next Update: Thursday, April 25, 2024 2:50 AM CDT

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GILLIAM, CONNIE SUE
Practice Address: JACKSON COUNTY MEMORIAL HOSPITAL HOME HEALTH
1204 W. TAMARACK ROAD
ALTUS OK 73521

Address last updated on 12/26/2023
Phone #: (580) 379-6900
Fax #:
County: JACKSON
License: 805
Dated: 9/2/1999
Expires: 1/31/2025
Temp. Ltr. Issued: 7/1/1999
Temp. Ltr. Expires: 9/25/1999
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:
JACKSON COUNTY MEMORIAL HOSPITAL HOME HEALTH
1204 W. TAMARACK ROAD
ALTUS OK 73521

Phone #: (580) 379-6900
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
KIRSTIE LEA SHIVE PT 2808

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