THEODORE J LAVAQUE Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071001884

License Status

INACTIVE

Business

First Name

THEODORE J

Last Name

LAVAQUE

Business Name

THEODORE J LAVAQUE

Original Issue Date

06/26/1975

Effective Date

04/05/2007

Expiration Date

09/30/2008

City

CROSSVILLE

State

Zip

38558

County

TENNESSEE

Ever Disciplined

LastModifiedDate

07/10/2008