KIMBERLY R BACALLA Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096004035

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

Last Name

BACALLA

Business Name

KIMBERLY R BACALLA

Original Issue Date

08/12/2015

Effective Date

05/31/2018

Expiration Date

09/30/2020

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

01/14/2021