STEPHEN MATTHEW BROADDUS - Athletic Trainer License in Illinois | # 096002618

STEPHEN MATTHEW BROADDUS

Business Entity

INACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002618

License Status

INACTIVE

Business

N

First Name

STEPHEN

Middle

MATTHEW

Last Name

BROADDUS

Business Name

STEPHEN MATTHEW BROADDUS

Original Issue Date

06/19/2008

Effective Date

05/05/2010

Expiration Date

05/31/2012

State

IL

Ever Disciplined

N

LastModifiedDate

03/08/2012