SUSAN H WEISS Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149007471

License Status

INACTIVE

Business

First Name

SUSAN H

Last Name

WEISS

Business Name

SUSAN H WEISS

Original Issue Date

02/19/1997

Effective Date

12/01/2005

Expiration Date

11/30/2007

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/05/2007