MARIETTA H MATHIS Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004745

License Status

INACTIVE

Business

First Name

MARIETTA H

Last Name

MATHIS

Business Name

MARIETTA H MATHIS

Original Issue Date

04/03/1992

Effective Date

12/01/2007

Expiration Date

11/30/2009

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/02/2009