KATHLEEN L BERGQUIST Social Worker License verification

Business Entity

INACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149011038

License Status

INACTIVE

Business

First Name

KATHLEEN

Middle

Last Name

BERGQUIST

Business Name

KATHLEEN L BERGQUIST

Original Issue Date

07/29/2004

Effective Date

07/29/2004

Expiration Date

11/30/2005

City

HENDERSON

State

Zip

89014

County

NEVADA

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

12/16/2005