BROOKE TAYLOR FOURTHMAN DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****11

License Status

NOT RENEWED

Business

Title

DVM

First Name

BROOKE

Middle

TAYLOR

Last Name

FOURTHMAN

Business Name

BROOKE TAYLOR FOURTHMAN DVM

Original Issue Date

05/19/2020

Effective Date

01/13/2021

Expiration Date

01/31/2023

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/31/2023