AMY NICOLE NICHOLS Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149011106

License Status

INACTIVE

Business

First Name

AMY

Middle

NICOLE

Last Name

NICHOLS

Business Name

AMY NICOLE NICHOLS

Original Issue Date

08/30/2004

Effective Date

12/01/2007

Expiration Date

11/30/2009

City

FORT COLLINS

State

Zip

80525

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/02/2009