TARA D. WALLACE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149023681

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

WALLACE

Business Name

TARA D. WALLACE

Original Issue Date

08/23/2021

Effective Date

08/23/2021

Expiration Date

02/28/2022

City

TOPEKA

State

Zip

66606

County

KANSAS

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

07/27/2022