BRUCE ANTHONY IVAN Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXING SECOND

License Number

002164187-0010

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

ANTHONY

Last Name

IVAN

Business Name

BRUCE ANTHONY IVAN

Original Issue Date

12/20/2004

Effective Date

12/20/2004

Expiration Date

10/01/2005

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006