SHANE PATRICK LONG Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149008393

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

PATRICK

Last Name

LONG

Business Name

SHANE PATRICK LONG

Original Issue Date

11/06/1998

Effective Date

01/14/2004

Expiration Date

11/30/2003

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006