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PIASECKI, KENDRA LEIGH       
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: 611 SW C AVE
LAWTON OK 73501

Address last updated on 10/21/2010
Phone #: (580) 355-1176
Fax #:
County: COMANCHE
License: 494
Dated: 6/23/2006
Expires: 10/31/2006
Temp. Ltr. Issued: 6/8/2006
Temp. Ltr. Expires: 7/22/2006
License Type: Provisional Dietitian
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 0
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:
611 SW C AVE
LAWTON OK 73501

Phone #: (580) 355-1176
Fax #:

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