KEITH ALAN BULLOCK Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149014572

License Status

ACTIVE

Business

First Name

KEITH

Middle

ALAN

Last Name

BULLOCK

Business Name

KEITH ALAN BULLOCK

Original Issue Date

01/20/2011

Effective Date

10/10/2025

Expiration Date

11/30/2027

City

OAK PARK

State

Zip

60304

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/10/2025