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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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CANTRELL, LYDIA FORREST       
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: 2603 OLD 98 ROAD
VALLIANT OK 74764

Address last updated on 10/16/2024
Phone #: (580) 212-5627
Fax #:
County: MCCURTAIN
License: 5381
Dated: 9/18/2019
Expires: 10/31/2025
License Type: Occupational 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:
2603 OLD 98 ROAD
VALLIANT OK 74764

Phone #: (580) 212-5627
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JUSTIN CLARK BLACK OA 1513
CHELSEA NICHOLE BURNS OA 1969
NICOLE MARIE MILLWARD OA 2615

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