KELLY S LAROSA Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001132

License Status

INACTIVE

Business

First Name

KELLY S

Last Name

LAROSA

Business Name

KELLY S LAROSA

Original Issue Date

12/22/1989

Effective Date

10/09/2019

Expiration Date

02/28/2022

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/15/2021