License holder summary

EVAN M FORMAN is a Temporary Psychologist licensed to practice in Pennsylvania. The address on file for EVAN M FORMAN is Philadelphia PA 19119. This licensed professional license is not current. The license was granted 08/17/2001 and expired on 01/17/2002.

Pennsylvania

Department of State

EVAN M FORMAN
Temporary Psychologist
License number
TPS029852
Date granted
08/17/2001
Date expires
01/17/2002
Class
Temporary Psychologist
Status
Voided
Address
Philadelphia PA 19119
palicensing.org
ID 17372000
LAST UPDATED 2024-04-29 20:33:17 UTC

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