ANDREW B WALLACE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149009951

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

Last Name

WALLACE

Business Name

ANDREW B WALLACE

Original Issue Date

02/02/2002

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

MILLBRAE

State

Zip

94030

County

CALIFORNIA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006