PAUL W JACOB Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001590

License Status

NOT RENEWED

Business

First Name

PAUL W

Last Name

JACOB

Business Name

PAUL W JACOB

Original Issue Date

04/28/1990

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006