License holder summary

Stacy Ellen Lake is a Athletic Trainer licensed to practice in Indiana. The address on file for Stacy Ellen Lake is Fort Wayne IN 46845. This licensed professional license is current. The license was granted 12/22/1999 and expired on 12/31/2014.

Indiana

Professional Licensing Agency

Stacy Ellen Lake
Athletic Trainer
License number
36000573A
Date granted
12/22/1999
Date expires
12/31/2014
Class
Athletic Trainer
Status
Active
Address
Fort Wayne IN 46845
indianalicensing.org
ID 1741694
LAST UPDATED 2024-05-03 12:26:05 UTC

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