ROGER D CLARK PHD Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000715

License Status

INACTIVE

Business

First Name

ROGER D

Last Name

CLARK

Suffix

PHD

Business Name

ROGER D CLARK PHD

Original Issue Date

04/26/1995

Effective Date

05/24/2002

Expiration Date

05/31/2002

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

09/11/2005