Wayne Mark Forman
InactiveIllinois license 046007414
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 046007414
- Status
- Inactive
- First issued
- August 10, 1981
- Expired
- March 31, 1984
- License holder
- Wayne Mark Forman
- Entity type
- Individual
Classifications
- Licensed Optometrist (Optometry) Vision & Hearing
Contact
Forest Hills, NY 11375
New York County