AMANDA KAY LAKE Marriage and Family Therapist License verification

Business Entity

NOT RENEWED

License Type

Marriage and Family Therapist

Description

LICENSED MARRIAGE AND FAMILY THERAPIST

License Number

166000869

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

KAY

Last Name

LAKE

Business Name

AMANDA KAY LAKE

Original Issue Date

06/22/2012

Effective Date

02/28/2017

Expiration Date

02/28/2019

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/18/2019