KEITH RICHARD DEDECKER - Athletic Trainer License in Illinois | # 096002622

KEITH RICHARD DEDECKER

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002622

License Status

NOT RENEWED

Business

N

First Name

KEITH

Middle

RICHARD

Last Name

DEDECKER

Business Name

KEITH RICHARD DEDECKER

Original Issue Date

07/08/2008

Effective Date

05/21/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021