MARISSA BROOKE SIEBEL Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002872

License Status

NOT RENEWED

Business

First Name

MARISSA

Middle

BROOKE

Last Name

SIEBEL

Business Name

MARISSA BROOKE SIEBEL

Original Issue Date

11/24/2009

Effective Date

05/25/2010

Expiration Date

05/31/2012

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/10/2012