LORI MIX BACON Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149016654

License Status

NOT RENEWED

Business

First Name

LORI

Middle

MIX

Last Name

BACON

Business Name

LORI MIX BACON

Original Issue Date

04/30/2014

Effective Date

04/30/2014

Expiration Date

11/30/2015

City

MEMPHIS

State

Zip

38134

County

TENNESSEE

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/08/2016