BRIAN L MATHIOT Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001123

License Status

NOT RENEWED

Business

First Name

BRIAN L

Last Name

MATHIOT

Business Name

BRIAN L MATHIOT

Original Issue Date

05/14/1998

Effective Date

05/21/2004

Expiration Date

05/31/2006

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/17/2006