BROCK L HASKINS FOWLER PSYD Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071010826

License Status

ACTIVE

Business

Title

PSYD

First Name

BROCK

Middle

Last Name

HASKINS FOWLER

Business Name

BROCK L HASKINS FOWLER PSYD

Original Issue Date

09/01/2022

Effective Date

10/25/2024

Expiration Date

09/30/2026

City

GREENSBORO

State

Zip

27406

Ever Disciplined

LastModifiedDate

03/31/2025