CAROLYN M KOCH Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149005483

License Status

NOT RENEWED

Business

First Name

CAROLYN M

Last Name

KOCH

Business Name

CAROLYN M KOCH

Original Issue Date

07/06/1993

Effective Date

12/01/2007

Expiration Date

11/30/2009

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/07/2010