PHYLLIS J WHITEHEAD Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149002279

License Status

NOT RENEWED

Business

First Name

PHYLLIS J

Last Name

WHITEHEAD

Business Name

PHYLLIS J WHITEHEAD

Original Issue Date

08/07/1990

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006