DAVID MICHAEL GROSSMAN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002005

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

MICHAEL

Last Name

GROSSMAN

Business Name

DAVID MICHAEL GROSSMAN

Original Issue Date

10/12/2004

Effective Date

10/12/2004

Expiration Date

05/31/2006

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

07/17/2006