GLEN OWEN SALLOWS Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071005808

License Status

NOT RENEWED

Business

First Name

GLEN

Middle

OWEN

Last Name

SALLOWS

Business Name

GLEN OWEN SALLOWS

Original Issue Date

01/12/1999

Effective Date

08/19/2004

Expiration Date

09/30/2006

City

MADISON

State

Zip

53719

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/08/2006