MARY T KELLY Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149011650

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

KELLY

Business Name

MARY T KELLY

Original Issue Date

10/19/2005

Effective Date

11/06/2017

Expiration Date

11/30/2019

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/23/2020