PENELOPE K SHAW Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001211

License Status

NOT RENEWED

Business

First Name

PENELOPE K

Last Name

SHAW

Business Name

PENELOPE K SHAW

Original Issue Date

12/22/1989

Effective Date

09/11/2013

Expiration Date

11/30/2015

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/08/2016