TINA MARIE SMITH Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001117

License Status

NOT RENEWED

Business

First Name

TINA MARIE

Last Name

SMITH

Business Name

TINA MARIE SMITH

Original Issue Date

04/14/1998

Effective Date

06/21/2002

Expiration Date

05/31/2002

City

SOUTH BELOIT

State

Zip

61080

County

BOONE

Ever Disciplined

LastModifiedDate

09/11/2005