CODY M WALLACE Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096005001

License Status

NOT RENEWED

Business

First Name

CODY

Middle

Last Name

WALLACE

Business Name

CODY M WALLACE

Original Issue Date

09/07/2019

Effective Date

10/01/2020

Expiration Date

05/31/2022

City

HAMPSHIRE

State

Zip

60140

County

KANE

Ever Disciplined

LastModifiedDate

07/27/2022