LAURA ALYCE BLACK Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149016083

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

ALYCE

Last Name

BLACK

Business Name

LAURA ALYCE BLACK

Original Issue Date

07/24/2013

Effective Date

10/02/2013

Expiration Date

11/30/2015

City

VALPARAISO

State

Zip

46383

County

INDIANA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/08/2016