Idaho
Division of Occupational and Professional Licenses
BRENT ROGER LEAVITT
Board Of Medicine
License number
PA-1299
Date granted
09/29/2015
Date expires
06/30/2017
Class
Board Of Medicine
Status
Licensed
Address
1550 elkcreek drive Idaho Falls ID 83404
idaholicensing.com
ID 48339211
LAST UPDATED 2024-03-22 11:46:14 UTC
LAST UPDATED 2024-03-22 11:46:14 UTC
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