JILL BLANK Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149003320

License Status

NOT RENEWED

Business

First Name

JILL

Last Name

BLANK

Business Name

JILL BLANK

Original Issue Date

03/29/1991

Effective Date

07/19/2010

Expiration Date

11/30/2011

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/05/2012