CHALISA L FONZA Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000550

License Status

NOT RENEWED

Business

First Name

CHALISA L

Last Name

FONZA

Business Name

CHALISA L FONZA

Original Issue Date

05/21/1993

Expiration Date

05/21/1995

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

09/04/2005