BETH ANN STAAKE Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002698

License Status

INACTIVE

Business

First Name

BETH

Middle

ANN

Last Name

STAAKE

Business Name

BETH ANN STAAKE

Original Issue Date

10/02/2008

Effective Date

05/20/2010

Expiration Date

05/31/2012

City

MEREDOSIA

State

Zip

62665

County

MORGAN

Ever Disciplined

LastModifiedDate

03/08/2012