LISA ANN FORMAN DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****21

License Status

NOT RENEWED

Business

First Name

LISA

Middle

ANN

Last Name

FORMAN

Suffix

DVM

Business Name

LISA ANN FORMAN DVM

Original Issue Date

08/10/2015

Effective Date

11/04/2022

Expiration Date

02/28/2025

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2025