DEREK R PEQUETTE Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001427

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

Last Name

PEQUETTE

Business Name

DEREK R PEQUETTE

Original Issue Date

10/10/2000

Effective Date

05/21/2018

Expiration Date

09/30/2020

City

BEECHER

State

Zip

60401

Ever Disciplined

LastModifiedDate

01/14/2021