SAMANTHA ROSE WAGNER Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149023091

License Status

ACTIVE

Business

First Name

SAMANTHA

Middle

ROSE

Last Name

WAGNER

Business Name

SAMANTHA ROSE WAGNER

Original Issue Date

03/10/2021

Effective Date

11/25/2025

Expiration Date

11/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/25/2025