BETH JOY BLACKBIRD Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071005363

License Status

INACTIVE

Business

First Name

BETH JOY

Last Name

BLACKBIRD

Business Name

BETH JOY BLACKBIRD

Original Issue Date

03/05/1997

Effective Date

06/11/2007

Expiration Date

09/30/2008

City

GRAND RAPIDS

State

Zip

49507

County

MICHIGAN

Ever Disciplined

LastModifiedDate

07/10/2008