ANNA FAIRBANKS DEKLEVA - Social Worker License in Illinois | # 149017553

ANNA FAIRBANKS DEKLEVA

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149017553

License Status

NOT RENEWED

Business

N

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

State

IL

Specialty/Qualifier

MASTERS

Ever Disciplined

N

LastModifiedDate

01/23/2020