LAURA MARIE PROVANCAL Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149019272

License Status

ACTIVE

Business

First Name

LAURA

Middle

MARIE

Last Name

PROVANCAL

Business Name

LAURA MARIE PROVANCAL

Original Issue Date

04/10/2017

Effective Date

09/15/2025

Expiration Date

11/30/2027

City

WHEATON

State

Zip

60189

County

DUPAGE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/15/2025