J DAVID CROCKETT Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072001700

License Status

CANCELLED

Business

First Name

J DAVID

Last Name

CROCKETT

Business Name

J DAVID CROCKETT

Original Issue Date

01/02/1974

Expiration Date

09/30/1990

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

09/04/2005