THOMAS B JACKSON Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149007063

License Status

NOT RENEWED

Business

First Name

THOMAS B

Last Name

JACKSON

Business Name

THOMAS B JACKSON

Original Issue Date

05/21/1996

Effective Date

07/15/2005

Expiration Date

11/30/2005

City

INDIANAPOLIS

State

Zip

46235

County

INDIANA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

12/16/2005