MIRIAM STARK PARENT Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071004899

License Status

INACTIVE

Business

First Name

MIRIAM

Last Name

STARK PARENT

Business Name

MIRIAM STARK PARENT

Original Issue Date

07/25/1994

Effective Date

08/20/2018

Expiration Date

09/30/2020

City

WESTERLO

State

Zip

12193

County

LAKE

Ever Disciplined

LastModifiedDate

07/27/2020