THOR MARTIN JOHANSEN Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071007301

License Status

INACTIVE

Business

First Name

THOR

Middle

MARTIN

Last Name

JOHANSEN

Business Name

THOR MARTIN JOHANSEN

Original Issue Date

06/29/2007

Effective Date

07/19/2018

Expiration Date

09/30/2020

City

PRESCOTT VALLEY

State

Zip

86314

Ever Disciplined

LastModifiedDate

07/27/2020