License holder summary

Dr. MITCHELL D FORMAN is a Medical Board - 34.Doctor Of Osteopathic Medicine licensed to practice in Ohio. The address on file for Dr. MITCHELL D FORMAN is UNIV OF NO TEXAS TCOM, 3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107. This licensed professional license is not current. The license was granted 06/21/1974 and expired on 01/01/2001.

Ohio

Board of Licensing

Dr. MITCHELL D FORMAN
Medical Board - 34.Doctor Of Osteopathic Medicine
License number
34.002258
Date granted
06/21/1974
Date expires
01/01/2001
Class
Medical Board - 34.Doctor Of Osteopathic Medicine
Status
Inactive
Address
UNIV OF NO TEXAS TCOM, 3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107
ohiolicensing.org
ID 28479332
LAST UPDATED 2024-03-21 20:48:13 UTC

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