ROBERT P BLAZEL Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004435

License Status

INACTIVE

Business

First Name

ROBERT P

Last Name

BLAZEL

Business Name

ROBERT P BLAZEL

Original Issue Date

12/17/1991

Effective Date

10/22/2003

Expiration Date

11/30/2005

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

12/16/2005