MELISSA A BRUNGARD Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096003095

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

Last Name

BRUNGARD

Business Name

MELISSA A BRUNGARD

Original Issue Date

04/06/2011

Effective Date

03/14/2014

Expiration Date

05/31/2016

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/11/2016