ETHAN ELLIOT STARK PSYD Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071010910

License Status

ACTIVE

Business

Title

PSYD

First Name

ETHAN

Middle

ELLIOT

Last Name

STARK

Business Name

ETHAN ELLIOT STARK PSYD

Original Issue Date

12/22/2022

Effective Date

09/17/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60647

Ever Disciplined

LastModifiedDate

09/17/2024