AMY R CARMEN Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149003843

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

CARMEN

Business Name

AMY R CARMEN

Original Issue Date

09/03/1991

Effective Date

10/13/2009

Expiration Date

11/30/2011

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/05/2012