IAN V PROVO Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150005052

License Status

NOT RENEWED

Business

First Name

IAN V

Last Name

PROVO

Business Name

IAN V PROVO

Original Issue Date

06/09/1993

Expiration Date

11/30/1995

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

12/16/2005