CAROLYN J BLACK Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149003454

License Status

INACTIVE

Business

First Name

CAROLYN J

Last Name

BLACK

Business Name

CAROLYN J BLACK

Original Issue Date

04/09/1991

Effective Date

09/25/2017

Expiration Date

11/30/2019

City

INDIANAPOLIS

State

Zip

46204

County

INDIANA

Specialty/Qualifier

DOCTORATE

Ever Disciplined

LastModifiedDate

09/04/2019