KEITH M WILSON Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071005137

License Status

INACTIVE

Business

First Name

KEITH M

Last Name

WILSON

Business Name

KEITH M WILSON

Original Issue Date

12/06/1995

Effective Date

08/25/2010

Expiration Date

09/30/2012

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

07/05/2012