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STATE OF ARKANSAS Ruthie Bain Executive Director SOCIAL WORK LICENSING BOARD Asa Hutchinson Governor Mailing Address PO Box 251965 Little Rock AR 72225 Street Address 2020 West Third Suite 518 Phone 501-372-5071 Fax 501-372-6301 Email swlb arkansas. Have you ever been pleaded guilty or nolo contendere to or been found guilty of any of the following 1 Any offenses specifically enumerated in A. Revised Signature Date SUMMARY SHEET FOR REPORTING SWCE Expiration Date Name of Licensee License No....

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