Name | WAGNER WILLIAM LEVINE |
---|---|
Address | LAGUNA BEACHCA |
Profession | LICENSED MASTER SOCIAL WORK |
License No | 003929 |
Date of Licensure | 09/01/04 (OriginallylicensedasaCertifiedSocialWorkeron11/10/67) |
Additional Qualification | |
Status | INACTIVE |
Registered through last day of |