DOUGLAS A FOWLER Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000665

License Status

NOT RENEWED

Business

First Name

DOUGLAS A

Last Name

FOWLER

Business Name

DOUGLAS A FOWLER

Original Issue Date

08/25/1994

Effective Date

07/17/2000

Expiration Date

05/31/2000

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/11/2005