ELLEN PETACQUE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149007355

License Status

ACTIVE

Business

First Name

ELLEN

Last Name

PETACQUE

Business Name

ELLEN PETACQUE

Original Issue Date

11/25/1996

Effective Date

11/03/2025

Expiration Date

11/30/2027

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/03/2025