License holder summary

SHELLEY M FORMAN is a Psychologist - Master's Ltd. Psychologist licensed to practice in Michigan. The address on file for SHELLEY M FORMAN is Northbrook, IL 60062. This licensed professional license is not current. The license was granted 10/31/1979 and expired on 08/31/2002.

Michigan

Department of Licensing and Regulation

SHELLEY M FORMAN
Psychologist - Master's Ltd. Psychologist
License number
6301003190
Date granted
10/31/1979
Date expires
08/31/2002
Class
Psychologist - Master's Ltd. Psychologist
Status
Lapsed
Address
Northbrook, IL 60062
michiganlicensing.org
ID 26024486
LAST UPDATED 2024-03-21 14:54:31 UTC

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