BERNARD G FARESTAD Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071001439

License Status

NOT RENEWED

Business

First Name

BERNARD G

Last Name

FARESTAD

Business Name

BERNARD G FARESTAD

Original Issue Date

02/16/1972

Expiration Date

11/01/1982

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/03/2005