JACOB WILLIAM BLASINGAME Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096003389

License Status

NOT RENEWED

Business

First Name

JACOB

Middle

WILLIAM

Last Name

BLASINGAME

Business Name

JACOB WILLIAM BLASINGAME

Original Issue Date

08/07/2012

Effective Date

04/08/2014

Expiration Date

05/31/2016

City

ST LOUIS

State

Zip

63146

County

MISSOURI

Ever Disciplined

LastModifiedDate

07/11/2016