MATTHEW EDWIN WALLACE - Athletic Trainer License in Nebraska | # 096002633

MATTHEW EDWIN WALLACE

Business Entity

NOT RENEWED

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096002633

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

EDWIN

Last Name

WALLACE

Business Name

MATTHEW EDWIN WALLACE

Original Issue Date

08/06/2008

Effective Date

08/06/2008

Expiration Date

05/31/2010

State

NE

Ever Disciplined

N

LastModifiedDate

08/11/2010