SUSAN R STATZ Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149007394

License Status

NOT RENEWED

Business

First Name

SUSAN R

Last Name

STATZ

Business Name

SUSAN R STATZ

Original Issue Date

12/24/1996

Effective Date

12/01/2007

Expiration Date

11/30/2009

City

DAKOTA

State

Zip

61018

County

STEPHENSON

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/07/2010