LEIF PHILIP MADSEN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002816

License Status

NOT RENEWED

Business

First Name

LEIF

Middle

PHILIP

Last Name

MADSEN

Business Name

LEIF PHILIP MADSEN

Original Issue Date

08/10/2009

Effective Date

04/12/2010

Expiration Date

05/31/2012

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

07/10/2012