KEITH T FOWLER Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150011069

License Status

INACTIVE

Business

First Name

KEITH

Middle

Last Name

FOWLER

Business Name

KEITH T FOWLER

Original Issue Date

06/06/2007

Effective Date

09/08/2009

Expiration Date

11/30/2011

City

FOREST PARK

State

Zip

60130

County

COOK

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

09/07/2011