BARBARA AUTREY H BLAYLOCK Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071002302

License Status

NOT RENEWED

Business

First Name

BARBARA AUTREY H

Last Name

BLAYLOCK

Business Name

BARBARA AUTREY H BLAYLOCK

Original Issue Date

05/22/1978

Effective Date

09/05/2012

Expiration Date

09/30/2014

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/17/2014