DAVID E WAGNER Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001158

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

WAGNER

Business Name

DAVID E WAGNER

Original Issue Date

12/22/1989

Effective Date

12/01/2005

Expiration Date

11/30/2007

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/04/2008