SAMANTHA BLAZEK Athletic Trainer License verification

Business Entity

ACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096005691

License Status

ACTIVE

Business

First Name

SAMANTHA

Last Name

BLAZEK

Business Name

SAMANTHA BLAZEK

Original Issue Date

08/22/2023

Effective Date

05/24/2024

Expiration Date

05/31/2026

City

MALTA

State

Zip

60150

County

DEKALB

Ever Disciplined

LastModifiedDate

03/04/2026