MATTHEW JOESEPH PASSALAQUA Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002145

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

JOESEPH

Last Name

PASSALAQUA

Business Name

MATTHEW JOESEPH PASSALAQUA

Original Issue Date

06/06/2005

Effective Date

04/19/2012

Expiration Date

05/31/2014

City

ADDISON

State

Zip

60101

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/03/2014