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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, November 5, 2024 10:12 AM CST
Next Update: Tuesday, November 5, 2024 12:00 PM CST

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GARDNER, LACEY JO       
Practice Address: ROWLAND FLATT CLINIC
603 NE 2ND STREET
ANTLERS OK 74523

Address last updated on 3/28/2024
Phone #: (580) 298-3351
Fax #:
County: PUSHMATAHA
License: 4503
Dated: 4/2/2021
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
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:
ROWLAND FLATT CLINIC
603 NE 2ND STREET
ANTLERS OK 74523

Phone #: (580) 298-3351
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DAVID CAMPBELL DO 4465
VICTORIA E. PARDUE DO 2840
TEDDY RAY ROWLAND MD 14790

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