License holder summary

Leavitt, Douglas - Lake Health Emerg. Physicians is a Medical Board - 41.Pa Supervision Agreement licensed to practice in Ohio. The address on file for Leavitt, Douglas - Lake Health Emerg. Physicians is 6720 North Ridge Rd., Madison Medical Center, Madison, OH 44057. This licensed professional license is current. The license was granted 07/31/2012 and expired on 01/31/2015.

Ohio

Board of Licensing

Leavitt, Douglas - Lake Health Emerg. Physicians
Medical Board - 41.Pa Supervision Agreement
License number
41.14932-SA
Date granted
07/31/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
6720 North Ridge Rd., Madison Medical Center, Madison, OH 44057
ohiolicensing.org
ID 29516687
LAST UPDATED 2026-05-22 12:11:21 UTC

This website is unaffiliated with Ohio and its licensing agencies. Please verify all information directly with the relevant official government authority.

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