TODD MICHAEL JACOB Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001389

License Status

NOT RENEWED

Business

First Name

TODD

Middle

MICHAEL

Last Name

JACOB

Business Name

TODD MICHAEL JACOB

Original Issue Date

08/28/2000

Effective Date

06/01/2006

Expiration Date

05/31/2008

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/11/2008