AMANDA S BLACK Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002588

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

BLACK

Business Name

AMANDA S BLACK

Original Issue Date

02/28/2008

Effective Date

04/04/2016

Expiration Date

05/31/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/19/2018