RONALD W WAGNER Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001857

License Status

NOT RENEWED

Business

First Name

RONALD

Middle

Last Name

WAGNER

Business Name

RONALD W WAGNER

Original Issue Date

11/26/2003

Effective Date

09/20/2004

Expiration Date

05/31/2006

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

07/17/2006