BLAINE E QUINTANA Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXING SECOND

License Number

002165080-0010

License Status

NOT RENEWED

Business

First Name

BLAINE

Middle

Last Name

QUINTANA

Business Name

BLAINE E QUINTANA

Original Issue Date

04/16/2007

Effective Date

04/16/2007

Expiration Date

10/01/2007

City

KEARNEY

State

Zip

68845

County

NEBRASKA

Ever Disciplined

LastModifiedDate

11/08/2007