MATTHEW EDWIN WALLACE Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002633

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

EDWIN

Last Name

WALLACE

Business Name

MATTHEW EDWIN WALLACE

Original Issue Date

08/06/2008

Effective Date

08/06/2008

Expiration Date

05/31/2010

City

OMAHA

State

Zip

68106

County

NEBRASKA

Ever Disciplined

LastModifiedDate

08/11/2010