STACEY A BLANK Professional Counselor License verification

Business Entity

NOT RENEWED

License Type

Professional Counselor

Description

LICENSED PROFESSIONAL COUNSELOR

License Number

178000420

License Status

NOT RENEWED

Business

First Name

STACEY A

Last Name

BLANK

Business Name

STACEY A BLANK

Original Issue Date

12/06/1996

Expiration Date

03/31/1999

City

LOVELAND

State

Zip

80537

County

COLORADO

Ever Disciplined

LastModifiedDate

09/05/2005