OTA E ROADHOUSE Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149003984

License Status

INACTIVE

Business

First Name

OTA E

Last Name

ROADHOUSE

Business Name

OTA E ROADHOUSE

Original Issue Date

09/04/1991

Effective Date

12/01/2005

Expiration Date

11/30/2007

City

WILMETTE

State

Zip

60091

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/05/2007