JACQUELINE D LEAVITT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

JACQUELINE

Middle

Last Name

LEAVITT

Suffix

Business Name

JACQUELINE D LEAVITT MD

Original Issue Date

04/17/1998

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/23/2023