AUDREY M BORTH Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071001986

License Status

INACTIVE

Business

First Name

AUDREY M

Last Name

BORTH

Business Name

AUDREY M BORTH

Original Issue Date

07/21/1976

Expiration Date

09/30/1994

City

KENOSHA

State

Zip

53143

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/03/2005