JASON JOSEF BLAKE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149010637

License Status

ACTIVE

Business

First Name

JASON

Middle

JOSEF

Last Name

BLAKE

Business Name

JASON JOSEF BLAKE

Original Issue Date

09/17/2003

Effective Date

11/25/2025

Expiration Date

11/30/2027

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/25/2025