LAURITA M PROVANCAL Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149002677

License Status

ACTIVE

Business

First Name

LAURITA M

Last Name

PROVANCAL

Business Name

LAURITA M PROVANCAL

Original Issue Date

12/14/1990

Effective Date

10/01/2025

Expiration Date

11/30/2027

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/01/2025