KERI M SHAKE Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001721

License Status

NOT RENEWED

Business

First Name

KERI

Middle

Last Name

SHAKE

Business Name

KERI M SHAKE

Original Issue Date

10/23/2002

Effective Date

06/16/2004

Expiration Date

05/31/2004

City

LEBANON

State

Zip

62254

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/11/2005