FREDERICK DORNBACK Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071001211

License Status

INACTIVE

Business

First Name

FREDERICK

Last Name

DORNBACK

Business Name

FREDERICK DORNBACK

Original Issue Date

08/31/2010

Effective Date

08/06/2012

Expiration Date

09/30/2014

City

ELBURN

State

Zip

60119

County

KANE

Ever Disciplined

LastModifiedDate

07/03/2014