STACEY MARIE WALLACE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149009444

License Status

ACTIVE

Business

First Name

STACEY

Middle

MARIE

Last Name

WALLACE

Business Name

STACEY MARIE WALLACE

Original Issue Date

12/14/2000

Effective Date

11/04/2025

Expiration Date

11/30/2027

City

APISON

State

Zip

37302

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/04/2025