BRENT J VAN DOLAH Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150009347

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

Last Name

VAN DOLAH

Business Name

BRENT J VAN DOLAH

Original Issue Date

07/31/2003

Effective Date

11/07/2003

Expiration Date

11/30/2005

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

BACCALAUREATE

Ever Disciplined

LastModifiedDate

10/28/2006