DAVID W SHANE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149002871

License Status

NOT RENEWED

Business

First Name

DAVID W

Last Name

SHANE

Business Name

DAVID W SHANE

Original Issue Date

12/14/1990

Effective Date

09/07/2017

Expiration Date

11/30/2019

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/23/2020