SUSAN K LONG Athletic Trainer License verification

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096000410

License Status

INACTIVE

Business

First Name

SUSAN

Middle

Last Name

LONG

Business Name

SUSAN K LONG

Original Issue Date

06/25/1992

Effective Date

05/23/2011

Expiration Date

05/31/2012

City

FORT ATKINSON

State

Zip

53538

County

JEFFERSON

Ever Disciplined

LastModifiedDate

03/08/2012