KRISTINE LOUISE PETERSON Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149008133

License Status

NOT RENEWED

Business

First Name

KRISTINE

Middle

LOUISE

Last Name

PETERSON

Business Name

KRISTINE LOUISE PETERSON

Original Issue Date

06/02/1998

Effective Date

12/01/2003

Expiration Date

11/30/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006