SUSAN E BACK Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149007766

License Status

INACTIVE

Business

First Name

SUSAN E

Last Name

BACK

Business Name

SUSAN E BACK

Original Issue Date

08/13/1997

Expiration Date

11/30/1999

City

PHOENIX

State

Zip

85016

County

ARIZONA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

12/16/2005