GREGORY O PETTY Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004486

License Status

INACTIVE

Business

First Name

GREGORY O

Last Name

PETTY

Business Name

GREGORY O PETTY

Original Issue Date

12/30/1991

Effective Date

11/20/2017

Expiration Date

11/30/2019

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/04/2019