KEITH D GIBSON Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071004088

License Status

INACTIVE

Business

First Name

KEITH D

Last Name

GIBSON

Business Name

KEITH D GIBSON

Original Issue Date

02/17/1990

Expiration Date

09/30/1998

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/03/2005