KEITH VARNEL WALLACE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149012034

License Status

ACTIVE

Business

First Name

KEITH

Middle

VARNEL

Last Name

WALLACE

Business Name

KEITH VARNEL WALLACE

Original Issue Date

06/30/2006

Effective Date

11/10/2025

Expiration Date

11/30/2027

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/10/2025