OLGA SERGEEVNA LEAVITT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

OLGA

Middle

SERGEEVNA

Last Name

LEAVITT

Suffix

Business Name

OLGA SERGEEVNA LEAVITT MD

Original Issue Date

10/09/2018

Effective Date

10/09/2018

Expiration Date

09/30/2020

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021