NICOLE A BLACKOWICZ Athletic Trainer License verification

Business Entity

ACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096003503

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

BLACKOWICZ

Business Name

NICOLE A BLACKOWICZ

Original Issue Date

12/11/2012

Effective Date

04/23/2024

Expiration Date

05/31/2026

City

MUNDELEIN

State

Zip

60060

County

LAKE

Ever Disciplined

LastModifiedDate

03/04/2026