DOMINIQUE IDA BURGOS Athletic Trainer License verification

Business Entity

ACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096004934

License Status

ACTIVE

Business

First Name

DOMINIQUE

Middle

IDA

Last Name

BURGOS

Business Name

DOMINIQUE IDA BURGOS

Original Issue Date

08/05/2019

Effective Date

03/17/2024

Expiration Date

05/31/2026

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

03/04/2026