SAMANTHA SOPHIA DULLES Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149008298

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

SOPHIA

Last Name

DULLES

Business Name

SAMANTHA SOPHIA DULLES

Original Issue Date

09/10/1998

Effective Date

01/10/2002

Expiration Date

11/30/2001

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006