NICOLAS A KRUCKENBURG Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002038

License Status

NOT RENEWED

Business

First Name

NICOLAS

Middle

Last Name

KRUCKENBURG

Business Name

NICOLAS A KRUCKENBURG

Original Issue Date

12/03/2004

Effective Date

04/07/2014

Expiration Date

05/31/2016

City

HARVARD

State

Zip

60033

County

MCHENRY

Ever Disciplined

LastModifiedDate

07/11/2016