DAVID M NISSENBAUM Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000837

License Status

NOT RENEWED

Business

First Name

DAVID M

Last Name

NISSENBAUM

Business Name

DAVID M NISSENBAUM

Original Issue Date

02/17/1996

Expiration Date

05/31/1998

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

09/04/2005