DANIEL R MEDINA Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXING SECOND

License Number

002163427-0010

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

MEDINA

Business Name

DANIEL R MEDINA

Original Issue Date

04/18/2001

Effective Date

04/18/2001

Expiration Date

10/01/2001

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Ever Disciplined

LastModifiedDate

09/18/2006