TERRY W HANTACK Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004504

License Status

NOT RENEWED

Business

First Name

TERRY W

Last Name

HANTACK

Business Name

TERRY W HANTACK

Original Issue Date

01/06/1992

Effective Date

11/07/2003

Expiration Date

11/30/2005

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006