AMY E FORRER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112185

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

FORRER

Business Name

AMY E FORRER

Original Issue Date

08/23/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

SOMERVILLE

State

Zip

02144

Ever Disciplined

LastModifiedDate

11/06/2008