DANIEL N RUZICKA Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXING SECOND

License Number

002164619-0010

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

RUZICKA

Business Name

DANIEL N RUZICKA

Original Issue Date

11/16/2005

Effective Date

11/16/2005

Expiration Date

10/01/2007

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

11/08/2007