STACY C MALM Professional Counselor License verification

Business Entity

NOT RENEWED

License Type

Professional Counselor

Description

LICENSED PROFESSIONAL COUNSELOR

License Number

178002127

License Status

NOT RENEWED

Business

First Name

STACY

Middle

Last Name

MALM

Business Name

STACY C MALM

Original Issue Date

12/05/2001

Effective Date

05/04/2005

Expiration Date

03/31/2005

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005