STACEY MARIE WALLACE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150007802

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

MARIE

Last Name

WALLACE

Business Name

STACEY MARIE WALLACE

Original Issue Date

07/19/1999

Effective Date

01/10/2002

Expiration Date

11/30/2001

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006