MALLORY CATHERINE SAMPLE Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149015685

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

CATHERINE

Last Name

SAMPLE

Business Name

MALLORY CATHERINE SAMPLE

Original Issue Date

01/18/2013

Effective Date

09/11/2017

Expiration Date

11/30/2019

City

SAINT LOUIS

State

Zip

63109

County

MISSOURI

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/23/2020