License Detail

NameWAGNER WILLIAM LEVINE
AddressLAGUNA BEACHCA
ProfessionLICENSED MASTER SOCIAL WORK
License No003929
Date of Licensure09/01/04  (OriginallylicensedasaCertifiedSocialWorkeron11/10/67)
Additional Qualification
StatusINACTIVE
Registered through last day of

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