SHRUTI S POULSEN Professional Counselor License verification

Business Entity

NOT RENEWED

License Type

Professional Counselor

Description

TEMPORARY LICENSED CLINICAL PROFESSIONAL COUNSELOR

License Number

179000206

License Status

NOT RENEWED

Business

First Name

SHRUTI S

Last Name

POULSEN

Business Name

SHRUTI S POULSEN

Original Issue Date

11/07/1995

Expiration Date

09/05/1998

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/07/2005