BLAINE AARON KLOPOTEK Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001820

License Status

NOT RENEWED

Business

First Name

BLAINE

Middle

AARON

Last Name

KLOPOTEK

Business Name

BLAINE AARON KLOPOTEK

Original Issue Date

09/22/2003

Effective Date

05/27/2004

Expiration Date

05/31/2006

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

07/17/2006