MARK ANDREW LONG Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXER

License Number

002164440-0003

License Status

NOT RENEWED

Business

First Name

MARK

Middle

ANDREW

Last Name

LONG

Business Name

MARK ANDREW LONG

Original Issue Date

07/12/2005

Effective Date

07/12/2005

Expiration Date

10/01/2007

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

11/08/2007