AMY NICOLE PETERSEN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001226

License Status

NOT RENEWED

Business

First Name

AMY

Middle

NICOLE

Last Name

PETERSEN

Business Name

AMY NICOLE PETERSEN

Original Issue Date

03/03/1999

Effective Date

07/17/2000

Expiration Date

05/31/2000

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

09/11/2005