POLLY A BASTA Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150005033

License Status

NOT RENEWED

Business

First Name

POLLY

Middle

Last Name

BASTA

Business Name

POLLY A BASTA

Original Issue Date

05/17/1993

Expiration Date

11/30/1995

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

09/03/2005