STACIA I SUPER Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001292

License Status

INACTIVE

Business

First Name

STACIA I

Last Name

SUPER

Business Name

STACIA I SUPER

Original Issue Date

12/28/1989

Expiration Date

11/30/1991

City

CHEVY CHASE

State

Zip

20815

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/02/2005