KEITH T FOWLER Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149014889

License Status

ACTIVE

Business

First Name

KEITH

Middle

Last Name

FOWLER

Business Name

KEITH T FOWLER

Original Issue Date

09/08/2011

Effective Date

09/11/2025

Expiration Date

11/30/2027

City

FOREST PARK

State

Zip

60130

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/11/2025