AMY MARIE GUSTAFSON Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149027733

License Status

ACTIVE

Business

First Name

AMY

Middle

MARIE

Last Name

GUSTAFSON

Business Name

AMY MARIE GUSTAFSON

Original Issue Date

09/11/2024

Effective Date

09/12/2025

Expiration Date

11/30/2027

City

ROCKFORD

State

Zip

61109

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/12/2025