License holder summary

BRENT ROGER LEAVITT is a Board Of Medicine licensed to practice in Idaho. The address on file for BRENT ROGER LEAVITT is 1550 elkcreek drive Idaho Falls ID 83404. This licensed professional license is current. The license was granted 09/29/2015 and expired on 06/30/2017.

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 2024-03-04 10:03:35 UTC

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