BRIAN ALAN CZAJKA Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001275

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

ALAN

Last Name

CZAJKA

Business Name

BRIAN ALAN CZAJKA

Original Issue Date

09/03/1999

Effective Date

06/16/2004

Expiration Date

05/31/2004

City

DECATUR

State

Zip

62522

County

MACON

Ever Disciplined

LastModifiedDate

09/11/2005