DANIEL LELAND RALPH BLACK Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002166500-0016

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

LELAND RALPH

Last Name

BLACK

Business Name

DANIEL LELAND RALPH BLACK

Original Issue Date

03/17/2010

Effective Date

03/17/2010

Expiration Date

10/01/2011

City

SIOUX CITY

State

Zip

51109

County

IOWA

Ever Disciplined

LastModifiedDate

10/04/2011