DENISE ANN DERBY Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXING SECOND

License Number

002169047-0010

License Status

NOT RENEWED

Business

First Name

DENISE

Middle

ANN

Last Name

DERBY

Business Name

DENISE ANN DERBY

Original Issue Date

02/01/2017

Effective Date

02/01/2017

Expiration Date

09/30/2017

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

10/11/2017