License holder summary

GLENN RALPH LEAVITT is a Board Of Medicine licensed to practice in Idaho. The address on file for GLENN RALPH LEAVITT is 1550 ELK CREEK DRIVE IDAHO FALLS ID 83404. This licensed professional license is current. The license was granted 06/13/2005 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

GLENN RALPH LEAVITT
Board Of Medicine
License number
O-0365
Date granted
06/13/2005
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1550 ELK CREEK DRIVE IDAHO FALLS ID 83404
idaholicensing.com
ID 48339215
LAST UPDATED 2026-04-15 15:59:43 UTC

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