KIMBERLY M BLACKWELL Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001981

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

BLACKWELL

Business Name

KIMBERLY M BLACKWELL

Original Issue Date

09/14/2004

Effective Date

05/23/2014

Expiration Date

05/31/2016

City

CHICAGO

State

Zip

60655

County

COOK

Ever Disciplined

LastModifiedDate

07/11/2016