LEONARD P LACIVITA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089194

License Status

NOT RENEWED

Business

First Name

LEONARD

Middle

Last Name

LACIVITA

Suffix

Business Name

LEONARD P LACIVITA MD

Original Issue Date

07/30/1994

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

LIVONIA

State

Zip

48154

County

WAYNE

Ever Disciplined

LastModifiedDate

11/06/2008

Case Number

2004005164

Action

Fine

Discipline Start Date

12/24/2007

Discipline Reason

failure to supervise intense light application.