JERRY L STATEN Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149003679

License Status

NOT RENEWED

Business

First Name

JERRY L

Last Name

STATEN

Business Name

JERRY L STATEN

Original Issue Date

09/03/1991

Effective Date

01/10/2002

Expiration Date

11/30/2001

City

GLEN CARBON

State

Zip

62034

County

SAINT CLAIR

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006