LORI DANAE BROCKMANN Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096001800

License Status

INACTIVE

Business

First Name

LORI

Middle

DANAE

Last Name

BROCKMANN

Business Name

LORI DANAE BROCKMANN

Original Issue Date

07/18/2003

Effective Date

05/21/2004

Expiration Date

05/31/2004

City

FARMINGTON HILLS

State

Zip

48335

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/11/2005