In an effort to update and maintain an accurate list and database of veterinarians and technicians in the LVMA’s Districts 7 and 8 we are requesting the following form be completed by all licensed veterinarians and certified technicians. The information requested is strictly intended for SLVA use only and will be confidentially maintained.
Full Name:*
Home Address:*
Cell Phone:*
Primary E-mail Address:*
School / Year:
License Number:
Clinic Name:
Full Clinic Address:
Work Phone:
Practice Email Address:
Practice Web Address: