DARRELL D SAMPLE Massage Therapist License verification

Business Entity

NOT RENEWED

License Type

Massage Therapist

Description

LICENSED MASSAGE THERAPIST

License Number

227002768

License Status

NOT RENEWED

Business

First Name

DARRELL

Middle

Last Name

SAMPLE

Business Name

DARRELL D SAMPLE

Original Issue Date

02/23/2005

Effective Date

12/27/2010

Expiration Date

12/31/2012

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/21/2013