SAMANTHA ROSE WAGNER Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED SOCIAL WORKER

License Number

150103029

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

ROSE

Last Name

WAGNER

Business Name

SAMANTHA ROSE WAGNER

Original Issue Date

02/20/2018

Effective Date

11/04/2019

Expiration Date

02/28/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

07/27/2022