ANDREA J WAGNER Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004285

License Status

NOT RENEWED

Business

First Name

ANDREA J

Last Name

WAGNER

Business Name

ANDREA J WAGNER

Original Issue Date

12/17/1991

Effective Date

11/10/2003

Expiration Date

11/30/2005

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006