FREDERICK DORNBACK Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072001211

License Status

CANCELLED

Business

First Name

FREDERICK

Last Name

DORNBACK

Business Name

FREDERICK DORNBACK

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

ELBURN

State

Zip

60119

County

KANE

Ever Disciplined

LastModifiedDate

09/04/2005