AMY BAGLEY MADSEN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001594

License Status

NOT RENEWED

Business

First Name

AMY

Middle

BAGLEY

Last Name

MADSEN

Business Name

AMY BAGLEY MADSEN

Original Issue Date

01/07/2002

Effective Date

06/03/2004

Expiration Date

05/31/2006

City

BROOKFIELD

State

Zip

60513

County

COOK

Ever Disciplined

LastModifiedDate

07/17/2006