MICHAEL CHURCH BAUM Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072002404

License Status

CANCELLED

Business

First Name

MICHAEL CHURCH

Last Name

BAUM

Business Name

MICHAEL CHURCH BAUM

Original Issue Date

11/28/1978

Expiration Date

09/30/1990

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/04/2005