License Detail

NameDAWSON RUTH IRENE
AddressROCHESTERNY
ProfessionLICENSED CLINICAL SOCIAL WORK
License No007197
Date of Licensure09/01/04  (OriginallylicensedasaCertifiedSocialWorkeron09/17/68)
Additional QualificationR -Psychotherapy Privilege
StatusINACTIVE
Registered through last day of

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