MICHAEL HOWARD BLACKBURN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002556

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

HOWARD

Last Name

BLACKBURN

Business Name

MICHAEL HOWARD BLACKBURN

Original Issue Date

11/02/2007

Effective Date

03/07/2008

Expiration Date

05/31/2010

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

08/11/2010