MARY C FAIRCHILD Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149010948

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

FAIRCHILD

Business Name

MARY C FAIRCHILD

Original Issue Date

06/09/2004

Effective Date

10/22/2019

Expiration Date

02/28/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

07/27/2022