REGINA RENEE THEOBALD Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002136

License Status

NOT RENEWED

Business

First Name

REGINA

Middle

RENEE

Last Name

THEOBALD

Business Name

REGINA RENEE THEOBALD

Original Issue Date

05/24/2005

Effective Date

06/01/2006

Expiration Date

05/31/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

07/11/2008