JUDITH MICKENBERG Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149005453

License Status

NOT RENEWED

Business

First Name

JUDITH

Last Name

MICKENBERG

Business Name

JUDITH MICKENBERG

Original Issue Date

06/15/1993

Effective Date

12/01/2003

Expiration Date

11/30/2005

City

HOLLISTON

State

Zip

01746

County

MASSACHUSETTS

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

10/28/2006