License holder summary

Ethan Grant Formo is a Medical - Athletic Trainer licensed to practice in Minnesota. The address on file for Ethan Grant Formo is 8015 4th Avenue S., Bloomington, MN 55420. This licensed professional license is current. The license was granted 11/14/2009 and expired on 06/30/2015.

Minnesota

Department of Labor and Industry

Ethan Grant Formo
Medical - Athletic Trainer
License number
2172
Date granted
11/14/2009
Date expires
06/30/2015
Class
Medical - Athletic Trainer
Status
Active
Address
8015 4th Avenue S., Bloomington, MN 55420
mnlicensing.org
ID 22346018
LAST UPDATED 2024-04-25 17:38:01 UTC

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