W EDWARD DIRKS Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000074

License Status

INACTIVE

Business

First Name

W EDWARD

Last Name

DIRKS

Business Name

W EDWARD DIRKS

Original Issue Date

06/23/1986

Expiration Date

05/31/1996

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

09/04/2005