RAE L PUTLACK Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149002309

License Status

NOT RENEWED

Business

First Name

RAE L

Last Name

PUTLACK

Business Name

RAE L PUTLACK

Original Issue Date

08/07/1990

Effective Date

12/23/2003

Expiration Date

11/30/2005

City

GLENCOE

State

Zip

60022

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006