ANNA FAIRBANKS DEKLEVA Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149017553

License Status

NOT RENEWED

Business

First Name

ANNA

Middle

FAIRBANKS

Last Name

DEKLEVA

Business Name

ANNA FAIRBANKS DEKLEVA

Original Issue Date

04/28/2015

Effective Date

10/10/2017

Expiration Date

11/30/2019

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/23/2020