KEITH RICHARD DEDECKER Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002622

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

RICHARD

Last Name

DEDECKER

Business Name

KEITH RICHARD DEDECKER

Original Issue Date

07/08/2008

Effective Date

05/21/2018

Expiration Date

09/30/2020

City

NAPERVILLE

State

Zip

60564

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021