WALTER R BLASE Athletic Trainer License verification

Business Entity

ACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000717

License Status

ACTIVE

Business

First Name

WALTER R

Last Name

BLASE

Business Name

WALTER R BLASE

Original Issue Date

04/26/1995

Effective Date

05/22/2024

Expiration Date

05/31/2026

City

ROSWELL

State

Zip

30075

County

GEORGIA

Ever Disciplined

LastModifiedDate

03/04/2026