NATHANIEL H EISEN Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072000152

License Status

NOT RENEWED

Business

First Name

NATHANIEL H

Last Name

EISEN

Business Name

NATHANIEL H EISEN

Original Issue Date

01/01/1998

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/04/2005