AMY FORMAN TAUB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

AMY FORMAN

Last Name

TAUB

Business Name

AMY FORMAN TAUB MD

Original Issue Date

11/17/1987

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

LINCOLNSHIRE

State

Zip

60069

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023