SAMANTHA L BLAKELY Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002917

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

BLAKELY

Business Name

SAMANTHA L BLAKELY

Original Issue Date

05/17/2010

Effective Date

05/17/2010

Expiration Date

05/31/2012

City

BATAVIA

State

Zip

60510

County

KANE

Ever Disciplined

LastModifiedDate

07/10/2012