SAMANTHA RENEE FORMENTO - Speech-Language Pathologist License in Illinois | # 242004617

SAMANTHA RENEE FORMENTO

Business Entity

EXPIRED

License Type

Speech-Language Pathologist

Description

LICENSED SPEECH LANGUAGE PATHOLOGY TEMPORARY

License Number

242004617

License Status

EXPIRED

Business

N

First Name

SAMANTHA

Middle

RENEE

Last Name

FORMENTO

Business Name

SAMANTHA RENEE FORMENTO

Original Issue Date

08/04/2017

Effective Date

08/04/2017

Expiration Date

08/04/2018

State

IL

Ever Disciplined

N

LastModifiedDate

12/04/2018