SAMANTHA RENEE FORMENTO Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146014180

License Status

ACTIVE

Business

First Name

SAMANTHA

Middle

RENEE

Last Name

FORMENTO

Business Name

SAMANTHA RENEE FORMENTO

Original Issue Date

04/06/2018

Effective Date

09/22/2025

Expiration Date

10/31/2027

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/22/2025