WAYNE E PUTNAM Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004771

License Status

NOT RENEWED

Business

First Name

WAYNE E

Last Name

PUTNAM

Business Name

WAYNE E PUTNAM

Original Issue Date

04/07/1992

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006