AMY E FORRER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

FORRER

Business Name

AMY E FORRER

Original Issue Date

09/13/2004

Effective Date

09/13/2004

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008