MARILYN A BOUSSUM Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072000891

License Status

NOT RENEWED

Business

First Name

MARILYN A

Last Name

BOUSSUM

Business Name

MARILYN A BOUSSUM

Original Issue Date

01/01/1998

Expiration Date

09/30/1986

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/04/2005