LESLIE J FYANS JR Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072002360

License Status

CANCELLED

Business

First Name

LESLIE J

Last Name

FYANS JR

Business Name

LESLIE J FYANS JR

Original Issue Date

05/22/1978

Expiration Date

09/30/1990

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/04/2005