VIENGKEO CHANTHALOTH-PHASOUK Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149022418

License Status

ACTIVE

Business

First Name

VIENGKEO

Last Name

CHANTHALOTH-PHASOUK

Business Name

VIENGKEO CHANTHALOTH-PHASOUK

Original Issue Date

08/06/2020

Effective Date

10/06/2025

Expiration Date

11/30/2027

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/06/2025