IAN V PROVO Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149006049

License Status

ACTIVE

Business

First Name

IAN V

Last Name

PROVO

Business Name

IAN V PROVO

Original Issue Date

07/30/1994

Effective Date

11/07/2025

Expiration Date

11/30/2027

City

LINCOLNSHIRE

State

Zip

61108

County

LAKE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/07/2025