MARY EVANS BLOSSOM - Social Worker License in Illinois | # 149017697

MARY EVANS BLOSSOM

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149017697

License Status

INACTIVE

Business

N

First Name

MARY

Middle

EVANS

Last Name

BLOSSOM

Business Name

MARY EVANS BLOSSOM

Original Issue Date

06/18/2015

Effective Date

11/14/2017

Expiration Date

11/30/2019

State

IL

Specialty/Qualifier

MASTERS

Ever Disciplined

N

LastModifiedDate

09/04/2019