LISA ANN FORMAN DVM Veterinarian License verification

Business Entity

ACTIVE

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****73

License Status

ACTIVE

Business

First Name

LISA

Middle

ANN

Last Name

FORMAN

Suffix

DVM

Business Name

LISA ANN FORMAN DVM

Original Issue Date

03/18/2020

Effective Date

11/07/2024

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/07/2024