ZOE ELLEN FORNBERG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009838

License Status

ACTIVE

Business

First Name

ZOE

Middle

ELLEN

Last Name

FORNBERG

Business Name

ZOE ELLEN FORNBERG

Original Issue Date

07/24/2023

Effective Date

03/05/2026

Expiration Date

03/01/2028

City

EVERGREEN PARK

State

Zip

60805

County

ADAMS

Ever Disciplined

LastModifiedDate

03/05/2026