IRVING MORTON FORMAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036028307

License Status

INACTIVE

Business

First Name

IRVING MORTON

Last Name

FORMAN

Suffix

Business Name

IRVING MORTON FORMAN MD

Original Issue Date

09/03/1947

Effective Date

09/03/1947

Expiration Date

07/31/1993

City

SANTA FE

State

Zip

87501

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

09/20/2006