COLLEEN M LEAVITT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101385

License Status

NOT RENEWED

Business

First Name

COLLEEN

Middle

Last Name

LEAVITT

Suffix

Business Name

COLLEEN M LEAVITT MD

Original Issue Date

09/30/1999

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

BALTIMORE

State

Zip

21218

Ever Disciplined

LastModifiedDate

04/06/2011