DAVID FAFOGLIA Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149005429

License Status

NOT RENEWED

Business

First Name

DAVID

Last Name

FAFOGLIA

Business Name

DAVID FAFOGLIA

Original Issue Date

06/01/1993

Effective Date

09/04/2019

Expiration Date

02/28/2022

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

07/27/2022