TY LAMAR WALLACE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149010121

License Status

ACTIVE

Business

First Name

Middle

LAMAR

Last Name

WALLACE

Business Name

TY LAMAR WALLACE

Original Issue Date

06/19/2002

Effective Date

11/25/2025

Expiration Date

11/30/2027

City

PINCKNEYVILLE

State

Zip

62274

County

PERRY

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/25/2025