KELLI D FORMAN
Social Work at Brian Loop, Lakeland, FL

License number
Florida 4160
Issued Date
Apr 18, 2006
Effective Date
Mar 24, 2011
Expiration Date
Mar 31, 2011
Category
Health Care
Type
Registered Clinical Social Worker Intern
Address
Address
7619 Brian Loop, Lakeland, FL 33810
Phone
(863) 287-6467
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Social Work licenses in Florida










Other General Professional services licenses in Florida