LAVERNE G CLARK Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002167125-0016

License Status

NOT RENEWED

Business

First Name

LAVERNE G

Last Name

CLARK

Business Name

LAVERNE G CLARK

Original Issue Date

09/20/2011

Effective Date

09/20/2011

Expiration Date

09/30/2013

City

DAVENPORT

State

Zip

52806

County

IOWA

Ever Disciplined

LastModifiedDate

11/21/2013