MICHAEL CHURCH BAUM Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071002404

License Status

INACTIVE

Business

First Name

MICHAEL CHURCH

Last Name

BAUM

Business Name

MICHAEL CHURCH BAUM

Original Issue Date

11/28/1978

Effective Date

07/11/2012

Expiration Date

09/30/2014

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/03/2014