MICHAEL J BALTHAZOR PHD Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071006684

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

Last Name

BALTHAZOR

Suffix

PHD

Business Name

MICHAEL J BALTHAZOR PHD

Original Issue Date

03/05/2004

Effective Date

09/23/2024

Expiration Date

09/30/2026

City

ANTIOCH

State

Zip

60002

County

LAKE

Ever Disciplined

LastModifiedDate

09/23/2024