MARY J CHURCHILL Social Worker License verification

Business Entity

NOT RENEWED

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149001200

License Status

NOT RENEWED

Business

First Name

MARY J

Last Name

CHURCHILL

Business Name

MARY J CHURCHILL

Original Issue Date

12/22/1989

Effective Date

11/21/2013

Expiration Date

11/30/2015

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

01/08/2016