DENISE S WALLACK Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071004180

License Status

NOT RENEWED

Business

First Name

DENISE S

Last Name

WALLACK

Business Name

DENISE S WALLACK

Original Issue Date

11/08/1990

Effective Date

11/08/1990

Expiration Date

09/30/1994

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

09/03/2005