TIFFANY ROSE CHURCH Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071006938

License Status

INACTIVE

Business

First Name

TIFFANY

Middle

ROSE

Last Name

CHURCH

Business Name

TIFFANY ROSE CHURCH

Original Issue Date

11/08/2005

Effective Date

08/06/2012

Expiration Date

09/30/2014

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/03/2014