FAWN A LEIGH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112140

License Status

ACTIVE

Business

First Name

FAWN

Middle

Last Name

LEIGH

Business Name

FAWN A LEIGH

Original Issue Date

08/18/2004

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

04/07/2023