WAYNE R MALAISE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149004835

License Status

NOT RENEWED

Business

First Name

WAYNE R

Last Name

MALAISE

Business Name

WAYNE R MALAISE

Original Issue Date

07/23/1992

Effective Date

09/12/2011

Expiration Date

11/30/2013

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

02/19/2014