LEONARD P LACIVITA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021904

License Status

EXPIRED

Business

First Name

LEONARD

Middle

Last Name

LACIVITA

Suffix

Business Name

LEONARD P LACIVITA MD

Original Issue Date

05/04/1988

Effective Date

05/04/1988

Expiration Date

07/01/1991

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006