CARRIE ANN BERGEN Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149013423

License Status

INACTIVE

Business

First Name

CARRIE

Middle

ANN

Last Name

BERGEN

Business Name

CARRIE ANN BERGEN

Original Issue Date

01/29/2009

Effective Date

10/16/2017

Expiration Date

11/30/2019

City

NEWPORT BEACH

State

Zip

92660

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/04/2019