ANNE I BERGSTROM Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149002014

License Status

NOT RENEWED

Business

First Name

ANNE I

Last Name

BERGSTROM

Business Name

ANNE I BERGSTROM

Original Issue Date

07/14/1990

Effective Date

11/06/2015

Expiration Date

11/30/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/04/2018