MICHAEL DUANE BROCKWAY Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002750

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

DUANE

Last Name

BROCKWAY

Business Name

MICHAEL DUANE BROCKWAY

Original Issue Date

03/04/2009

Effective Date

05/28/2010

Expiration Date

05/31/2012

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

07/10/2012