FOREST W PRICE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149000757

License Status

NOT RENEWED

Business

First Name

FOREST W

Last Name

PRICE

Business Name

FOREST W PRICE

Original Issue Date

10/07/1989

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

ROCKFORD

State

Zip

61101

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006