MYLIE BROOKE LEATHERMAN Athletic Trainer License verification

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096004445

License Status

NOT RENEWED

Business

First Name

MYLIE

Middle

BROOKE

Last Name

LEATHERMAN

Business Name

MYLIE BROOKE LEATHERMAN

Original Issue Date

05/19/2017

Effective Date

05/29/2018

Expiration Date

09/30/2020

City

MUSKOGEE

State

Zip

74401

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

01/14/2021