LACEY J VITALE Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002716

License Status

NOT RENEWED

Business

First Name

LACEY

Middle

Last Name

VITALE

Business Name

LACEY J VITALE

Original Issue Date

10/22/2008

Effective Date

05/16/2014

Expiration Date

05/31/2016

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/11/2016