COSTA D PROVIS Professional Counselor License verification

Business Entity

ACTIVE

License Type

Professional Counselor

Description

LICENSED CLINICAL PROFESSIONAL COUNSELOR

License Number

180005903

License Status

ACTIVE

Business

First Name

COSTA

Middle

Last Name

PROVIS

Business Name

COSTA D PROVIS

Original Issue Date

06/14/2005

Effective Date

01/09/2025

Expiration Date

03/31/2027

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

01/09/2025